Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-25T02:28:54.260Z Has data issue: false hasContentIssue false
  • English
  • Français

Relationship between non-cardiac chest pain and internalizing problems in pre-school aged children

Published online by Cambridge University Press:  16 July 2020

Tamer Yoldaş Open the ORCID record for Tamer Yoldaş [Opens in a new window] ,
Tuba Çelen Yoldaş ,
Meryem Beyazal ,
Ufuk İ. Sayıcı  and
Utku A. Örün
Tamer Yoldaş*
Affiliation:
Department of Paediatric Cardiology, Dr. Sami Ulus Maternity, Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
Tuba Çelen Yoldaş
Affiliation:
Department of Developmental and Behavioural Paediatrics, Dr. Sami Ulus Maternity, Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
Meryem Beyazal
Affiliation:
Department of Paediatric Cardiology, Dr. Sami Ulus Maternity, Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
Ufuk İ. Sayıcı
Affiliation:
Department of Paediatric Cardiology, Dr. Sami Ulus Maternity, Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
Utku A. Örün
Affiliation:
Department of Paediatric Cardiology, Dr. Sami Ulus Maternity, Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
*
Author for correspondence: Dr. Tamer Yoldaş, MD, Department of Paediatric Cardiology, Dr. Sami Ulus Maternity, Children’s Health and Diseases Training and Research Hospital Babür Caddesi, Babür Caddesi Number:44, Altındağ, Ankara6080, Turkey. Tel: +90 (312) 305 6570; Fax: +90 (312) 317 03 53. E-mail: tameryoldas@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Non-cardiac chest pain is a common and persistent problem for children; yet, typically, there is no clear medical cause. To date, no behavioural and/or psychological factors have been studied to explain chest pain in a pre-school paediatric sample. We hypothesized that pre-school children with medically unexplained chest pain would have higher rates of behavioural problems compared to healthy controls.

Methods:

We assessed 41 pre-school children with non-cardiac chest pain and 68 age matched children with benign heart murmurs as the control group using the Child Behaviour Check List-1 1/2–5 to evaluate emotional and behavioural problems.

Results:

Internalizing problem scores comprising emotionally reactive, anxiety/depression, and somatic complaints were higher in children with non-cardiac chest pain than in the control group. Among the possible factors, the factor that is related to behaviour problem scores, in univariate analysis, was a significant and inverse correlation between maternal education and behaviour problem scores. Also, maternal employment status was associated with behavioural problems. Children with a housewife mother were more susceptible to having such behavioural problems. Based on multiple regression analyses, being in the non-cardiac chest pain group was found to be significantly related to internalizing problems in our total sample.

Conclusions:

These results suggest that pre-school children with non-cardiac chest pain may experience increased levels of certain behavioural comorbidities. Systematic behavioural screening could increase the detection of behavioural problems and improve care for this population. Future studies of non-cardiac chest pain in pre-school children should include larger samples and comprehensive diagnostic assessments as well as long-term follow-up evaluations.

Keywords

Chest painpre-schoolchildrenbehavioural problem
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1261 - 1265
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Selbst, SM, Ruddy, RM, Clark, BJ.Pediatric chest pain: a prospective study. Pediatrics 1988; 82: 319–323. doi: 10.1177/000992289002901017Google ScholarPubMed
Gastesi Larrañaga, M, Fernández Landaluce, A, Mintegi Raso, S, Vázquez Ronco, M, Fernández, Benito. Chest pain in pediatric emergency departments: a usually benign process. An Pediatr (Barc) 2003; 59: 234–238. doi: 10.1016/s1695-4033(03)78172-7CrossRefGoogle ScholarPubMed
Massin, MM, Bourguignont, A, Coremans, C.Chest pain in pediatric patients presenting to an emergency department or to a cardiac clinic. Clin Pediatr (Phila) 2004; 43: 231–238. doi: 10.1177/000992280404300304CrossRefGoogle Scholar
Evangelista, JA, Parsons, M, Renneburg, AK.Chest pain in children: diagnosis through history and physical examination. J Pediatr Health Care 2000; 14: 3–8. doi: 10.1016/s0891-5245(00)70037-xCrossRefGoogle ScholarPubMed
Rowe, BH, Dulberg, CS, Peterson, RG, Vlad, P, Li, MM.Characteristics of children presenting with chest pain to a pediatric emergency department. CMAJ 1990; 143: 388–394.Google ScholarPubMed
Zavaras-Angelidou, KA, Weinhouse, E, Nelson, DB. . Review of 180 episodes of chest pain in 134 children. Pediatr Emerg Care 1992; 8: 189–193. doi: 10.1097/00006565-199208000-00004CrossRefGoogle ScholarPubMed
Talner, NS, Carboni, MP.Chest pain in the adolescent and young adult. Cardiol Rev 2000; 8: 49–56. doi: 10.1097/00045415-200008010-00009CrossRefGoogle ScholarPubMed
Thull-Freedman, J.Evaluation of chest pain in the pediatric patient. Med Clin North Am 2010; 94: 327–347. doi: 10.1016/j.mcna.2010.01.004CrossRefGoogle ScholarPubMed
Craig, TK, Cox, AD, Klein, K.Intergenerational transmission of somatization behaviour: a study of chronic somatizers and their children. Psychol Med 2000; 32: 805–816. doi: 10.1017/s0033291702005846Google Scholar
Walker, LS, Garber, J, Greene, JW.Somatic complaints in pediatric-patients: a prospective-study of the role of negative life events, child social and academic competence, and parental somatic symptoms. J Consult Clin Psychol 1994; 62: 1213–1221. doi: 10.1037//0022-006x.62.6.1213CrossRefGoogle ScholarPubMed
Veeram Reddy, SR, Singh, HR. Chest pain in children and adolescents. Pediatr Rev 2010; 31: e1–e9. doi: 10.1542/pir.31-1-e1CrossRefGoogle Scholar
Lipsitz, JD, Masia-Warner, C, Apfel, H, Marans, Z, Hellstern, B, Forand, N, et al.Anxiety and depressive symptoms and anxiety sensitivity in youngsters with non-cardiac chest pain and benign heart murmurs. J Pediatr Psychol 2010; 29: 607–612. doi: 10.1093/jpepsy/jsh062CrossRefGoogle Scholar
Lipsitz, JD, Masia-Warner, C, Apfel, H, Marans, Z, Gur, M, Dent, H, Fyer, AJ, et al.Non-cardiac chest pain and psychopathology in children and adolescents psychopathology in children and adolescents. J Psychosom Res 2005; 59: 185–188. doi: 10.1016/j.jpsychores.2005.05.004CrossRefGoogle Scholar
Tunaoglu, FS, Olgunturk, R, Akcabay, S, Oguz, D, Gucuyener, K, Demirsoy, S.Chest pain in children referred to a cardiology clinic. Pediatr Cardiol 1995; 16: 69–72. doi: 10.1007/bf00796820CrossRefGoogle ScholarPubMed
Carson, J, Weir, A, Chin, RF, McLellan, A.Socioeconomic deprivation is an independent risk factor for behavioral problems in children with epilepsy. Epilepsy Behav 2015; 45: 105–109. doi: 10.1016/j.yebeh.2015.03.009CrossRefGoogle ScholarPubMed
Warnick, EM, Bracken, BM, Kasl, S.Screening efficiency of the child behavior checklist and strengths and difficulties questionnaire: a systematic review. Child Adolesc Ment Health 2008; 13: 140–147. doi: 10.1111/j.1475-3588.2007.00461.xCrossRefGoogle ScholarPubMed
Erol, N, Simsek, Z, Oner, O, Munir, K.Behavioral and emotional problems among Turkish children at ages 2 to 3 years. J Am Acad Child Adolesc Psychiatry 2005; 44: 80–87. doi:10.1097/01.chi.0000145234.18056.82CrossRefGoogle ScholarPubMed
Yurduşen, S, Erol, N, Gençöz, T.The effects of parental attitudes and mothers’ psychological well-being on the emotional and behavioral problems of their pre-school children. Matern Child Health J 2013; 17: 68–75. doi: 10.1007/s10995-012-0946-6CrossRefGoogle Scholar
Yurdusen, S. The effects of mother’s parental attitudes on their pre-school children’s internalizing and externalizing behavior problems: the mediator role of mothers’ psychological adjustment. Dissertation, Middle East Technical University, 2004.Google Scholar
Lipsitz, JD, Gur, M, Sonnet, FM.Psychopathology and disability in children with unexplained chest pain presenting to the pediatric emergency department. Pediatr Emerg Care 2010; 26: 830–836. doi: 10.1097/pec.0b013e3181fb0e23CrossRefGoogle ScholarPubMed
Lipsitz, JD, Hsu, DT, Apfel, HD.Psychiatric disorders in youth with medicallyunexplained chest pain versus innocent heart murmur. J Pediatr 2012; 160: 320–324. doi: 10.1016/j.jpeds.2011.07.011CrossRefGoogle ScholarPubMed
Singh, H, Soni, PK, Gill, PJ, Kaur, L.Stressful family life events and non-spesific somatic complaints in school children. Indian Pediatr 1991; 28: 1483–1487.Google Scholar
Rickert, VI, Jay, MS.Psychosomatic disorders: the approach. Pediatr Rev 1994; 15: 448–454.CrossRefGoogle ScholarPubMed
Hodge, A, Firth, S, Bermejo, R, Zeck, W, Jimenez-Soto, E.Utilisation of health services and the poor: deconstructing wealth-based differences in facility-based delivery in the Philippines. BMC Public Health 2016; 16: 523. doi: 10.1186/s12889-016-3148-0CrossRefGoogle ScholarPubMed
Rowland, TW, Richards, MM.The natural history of idiopathic chest pain in children: a follow-up study. Clin Pediatr 1986; 25: 612–614.CrossRefGoogle ScholarPubMed
Lulla, D, Mascarenhas, SS, How How, C, Yeleswarapu, SP.An approach to problem behaviours in children. Singapore Med J 2019; 60: 168–172. doi: 10.11622/smedj.2019034.CrossRefGoogle ScholarPubMed