Depression in children with abdominal pain in the emergency department.

Abstract

Objective: This cross-sectional study examined depression and associated impairment in youth presenting to a pediatric emergency department (PED) with abdominal pain.

Methods: Participants were 11-17 years old, presenting to a PED with idiopathic abdominal pain. Participants completed demographics, pain, pain-related impairment, and depression surveys. Depression was assessed using the Patient Health Questionnaire (PHQ-9A). Scores ≥10 met depression threshold and ≥1 on item 9 indicated self-harm ideation. Mean difference and logistic regression analyses were conducted.

Results: Among 169 participants, 29.6% reported depression and 9.4% endorsed self-harm ideation. Depression was associated with Latinx ethnicity (X² = 4.02, p = 0.045), higher pain intensity (Z = -3.09, p = 0.002), and higher pain-related impairment (Z = -4.86, p < 0.001). In regression analyses, pain-related impairment and Latinx ethnicity were independently associated with depression (OR = 3.89 [95%CI, 1.22-12.40]; OR = 1.13 [95%CI, 1.06-1.21]). Self-harm ideation was not associated with study variables.

Conclusions: Results highlight the need for enhanced mental health screening for youth presenting with idiopathic abdominal pain in the ED, particularly for Latinx youth. Early identification of depression and high pain-related impairment may inform interventions and improve outcomes.

Impact: Nearly 30% of youth, 11-17 years old, presenting to the ED with idiopathic abdominal pain screened positive for depression and 9.4% reported self-harm ideation. The higher likelihood of depression among Latinx youth experiencing pain emphasizes the importance of including diverse samples in future ED research to explore mechanisms contributing to poorer mental health in minoritized populations. Results highlight the need for enhanced mental health screening in youth presenting to the emergency department with idiopathic abdominal pain.