Recurrent abdominal pain in adolescents with anxiety and depression disorders

Main Article Content

Fastralina Fastralina
Sri Sofyani
M. Joesoef Simbolon
Iskandar Z. Lubis


Background Anxiety and depression disorders in adolescents
may affect their academic performances and social functioning
at school. Adolescents with these disorders sometimes develop
recurrent abdominal pain (RAP).
Objective To assess the occurence of recurrent abdominal pain
among adolescents with anxiety and depression disorders
Methods We conducted a cross-sectional study from August
to September 2009 in 12-18 year-old adolescents from 3 junior
high schools and 3 senior high schools in Secanggang Subdistrict,
Langkat District, North Sumatera Province. We screened 960
adolescents. Subjects were selected by consecutive sampling
and instructed to fill the child behavior checklist (CBCL) and
children's depression inventory (CDI) forms. Those with suspected
anxiety/depression (CBCL score 2: 12 for boys and 2: 14 for girls)
and those with suspected depression (CDI score 2: 13) were then
examined by a psychiatrist. Adolescents diagnosed with anxiety or
depression disorders were instructed to fill the RAP questionnaire
based on Apley and Naish criteria.
Results From the CBCL and CDI forms, 250 students were
suspected of having anxiety and/or depression. From these,
144 students participated in this study. Of the 84 students with
anxiety disorders, 60 (71.4%) students suffered from RAP. Of
the 60 students with depression disorders, 31 (51 %) suffered
from RAP.
Conclusion Adolescents with anxiety or depression are more
likely to have recurrent abdominal pain.

Article Details

How to Cite
Fastralina F, Sofyani S, Simbolon M, Lubis I. Recurrent abdominal pain in adolescents with anxiety and depression disorders. PI [Internet]. 28Feb.2013 [cited 24Jan.2020];53(1):16-0. Available from:
Received 2016-08-18
Accepted 2016-08-18
Published 2013-02-28


1. Hoek W, Schuurmans J, Koot HM, Cuijpers P. Prevention
of depression and anxiety in adolescents: a randomized
controlled trial testing the efficacy and mechanisms of
internet-based self-help problem-solving therapy. Bio Med
Cent. 2009; 1-13.
2. Cartwright-Hatton S, McNicol K, Doubleday E. Anxiety in a
neglected population: prevalence of anxiety disorders in preadolescent
children. Clin Psycho! Rev. 2006;26:817-33.
3. Schapiro M. Anxiety disorders. In: Nevid JS, Rathus SA,
Greene B, editors. Abnormal psychology in a changing
world. 5th ed. Prentice Hall: Pearson Education; 2003. p.
4. Khan MS, Mahmood S, Badshah A, Ali SU, Jamal Y.
Prevalence of depression, anxiety and their associated factors
among medical students in Karachi, Pakistan. J Pak Med
Assoc. 2006;56:583-6.
5. Hishinuma ES, Miyamoto RH, Nishimura ST, Goebert GA,
Yuen NC, Makini GK, et al. Prediction of anxiety disorders
using the state- trait anxiety inventory for multiethnic
adolescents. J Anxiety Disord. 2001 ;15:511-33.
6. Thiessen PN. Recurrent abdominal pain. Pediatr Rev.
7. Campo JV, Bridge J, Ehmann M, Altman S, Lucas A,
Birmaher B, et al. Recurrent abdominal pain, anxiety, and
depression in primary care. Pediatrics. 2004; 113:817-24.
8. Dufton LM. Anxiety and somatic complaints in children with recurrent abdominal pain and anxiety disorder. J Pediatr
Psycho!. 2009;34: 176-86.
9. Hofflich AS, Hughes AA, Kendall PC. Somatic complaints
and childhood anxiety disorders. Int J Clin Health Psycho!.
10. Roza SJ, Hofstra MB, van der Ende J, Verhulst FC. Stable
prediction of mood and anxiety disorders based on behavioral
and emotional problems in childhood: a 14-year follow-up
during childhood, adolescence, and young adulthood. Am J
Psychiatry. 2003;160:2116-21.
11. Sadock BJ, Sadock VA. Generalized anxiety disorder. In:
Sadock BJ, Sadock VA, editors. Kaplan & Sadock's synopsis
of psychiatry. 9th ed. New York: Williams & Wilkins; 2000.
p. 632-6.
12. World Health Organization. Pedoman penggolongan clan
diagnosis gangguan jiwa di Indonesia. Jrd ed. Jakarta: Depkes
RI; 1993. p. 150-62.
13. Shahraki T, Farahmand F, Khatami GR, Najafi M, Shahraki
M. Recurrent abdominal pain: an etiological study among
in a referreal children's medical center in Iran. Iran J Ped.
2007; 17:235-40.
20 • Paediatr Ind.ones, Vol. 53, No. 1, January 2013
14. Greco LA, Freeman KE, Dufton L. Overt and relational
victimization among children with frequent abdominal pain:
links to social skill, academic functioning, and health service
use. J Pediatr Psycho!. 2007 ;32:320-29.
15. Kaminsky L, Robertson M, Dewey D. Psychological correlates
of depression in children with recurrent abdominal pain. J
Pediatr Psycho!. 2006;31:956-66.
16. Levy RL, Langer SL, Walker LS, Feld LD, Whitehead WE.
Relationship between the decision to take a child to the clinic
for abdominal pain and maternal psychological distress. Arch
Pediatr Adolesc Med. 2009; 160:961-5.
17. Galli F, D'Antuono G, Tarantino S, Viviano F, Borelli 0,
Chirumbolo A, et al. Headache and recurrent abdominal
pain: a controlled study by the means of the child behaviour
checklist (CBCL). Cephalalgia. 2007;27:211-9.
18. Master KS. Recurrent abdominal pain, medical intervention,
and biofeedback: what happened to the biopsychosocial model?
Appl Psychophysiol Biofeedback. 2006 ;31: 15 5-65 .
19. White KS, Farrell AD. Anxiety and psychosocial stress as
predictors of headache and abdominal pain in urban early
adolescents. J Pediatr Psycho!. 2005;3 l :582-96.