Screening evaluation of the depressive symptoms in children with combined functional dyspepsia and irritable bowel syndrome

Background. The course of combined functional dyspepsia and irritable bowel syndrome is characterized by more pronounced clinical symptoms and a deterioration in the quality of life. Depression is considered as one of the factors that aggravates gastrointestinal dysfunction. Purpose – improving early diagnosis of depressive disorders in children with combined functional gastrointestinal disorders (functional dyspepsia and irritable bowel syndrome) by using screening of the depressive symptoms. Materials and Methods. 97 children with functional gastrointestinal disorders aged 7–17 years were examined. The first group of the study included 39 children with combined functional dyspepsia and irritable bowel syndrome. The second group included 58 children with functional dyspepsia. Depressive symptoms were evaluated using adapted Ukrainian version of the Maria Kovacs Childrenʼs Depression Inventory. Results. The total indicators of depressive symptoms in children of the group I were higher than in children of the group II: on scale A «Depressive mood» (3.16 ± 0.06 vs 1.64 ± 0.11) (p < 0.001); on scale B «Interpersonal difficulties» (2.55 ± 0.24 vs 1.86 ± 0.15) (p < 0.001); on scale «Anhedonia» (6.45 ± 0.24 vs 4.31 ± 0.22) (p < 0.01); on scale E «Negative self-esteem» 3.42 ± 0.16 vs 1.59 ± 0.19 (p < 0.01). The summary indicator of depressive symptoms in children with combined functional dyspepsia and irritable bowel syndrome was higher than in children with functional dyspepsia (20.0 ± 0.78 vs 13.30 ± 0.37) (p < 0.001). The frequency of children who had summary indicator of depressive symptoms exceeded the cut-off value (19 points) in group I was higher than in group II (55.3% vs 8.4%) (p < 0.05). Direct correlations were found between severity of depressive symptoms and intensity of abdominal pain (r = 0.6; p < 0.01), and severity of stool disorders (r = 0.6; p < 0.01). Conclusions. The summary indicator of depressive symptoms exceeding the cut-off value was found in 25.7% of children with functional gastrointestinal disorders; among children with combined functional dyspepsia and irritable bowel syndrome this indicator was 55.3%. The frequency and severity of depressive symptoms on the scales «Depressed mood», «Anhedonia» and «Negative self-esteem» were significantly higher in children with combined functional dyspepsia and irritable bowel syndrome compared to those in children with FD along. In children with functional gastrointestinal disorders correlations between the severity of depressive symptoms and the intensity of abdominal pain and the severity of bowel disorders were found. The obtained data indicate that presence of depressive symptoms may be one of the factors contributing to the formation of the «overlap syndrome» of functional dyspepsia and irritable bowel syndrome.