Psychological comorbidity and stress reactivity in children and adolescents with recurrent abdominal pain and anxiety disorders

J Am Acad Child Adolesc Psychiatry. 2003 Jan;42(1):66-75. doi: 10.1097/00004583-200301000-00012.


Objective: To compare clinical symptoms, diagnoses, and physiological measures in children and adolescents with recurrent abdominal pain (RAP) (n = 14), to a group with anxiety disorders (ANX) (n = 14) and a physically and psychiatrically healthy control group (HC) (n = 14).

Method: The cross-sectional study examined group differences in clinical symptoms of anxiety, somatic complaints, depression, and behavior problems. Physiological measures included heart rate, systolic and diastolic blood pressure, and salivary cortisol in response to the Trier Social Stress Test for Children (TSST-C). Subjects were between the ages of 8 and 16 years.

Results: RAP and ANX subjects had comparable scores on most psychological measures, and their scores were higher (n < .05) than those of the HC. The ANX and RAP groups exhibited physiological findings that had more shared similarities than either group with the HC group. Few statistically significant group differences were noted in physiological measures, yet the pattern of findings in blood pressure and cortisol supported the use of the TSST-C and the direction of the findings was consistent with expectations.

Conclusions: Understanding more about comorbidity between RAP and anxiety could have important management implications, with observed congruities between the disorders suggesting treatments already demonstrated to be efficacious for pediatric anxiety and depression might be applied productively to RAP.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abdominal Pain / epidemiology*
  • Abdominal Pain / physiopathology
  • Adolescent
  • Analysis of Variance
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / physiopathology
  • Blood Pressure
  • Case-Control Studies
  • Child
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Heart Rate
  • Humans
  • Hydrocortisone / metabolism
  • Male
  • Pennsylvania / epidemiology
  • Recurrence


  • Hydrocortisone