School-Related Stressors, Pain Outcome Measures and Extremely Low Health-Related Quality of Life in a Representative Sample of Hungarian Adolescents With Functional Abdominal Pain Disorders.

Abstract

Background: Despite the growing body of evidence on paediatric chronic pain, there is a paucity of studies focusing on school stressors, internationally recommended core outcome measures for chronic pain and chronic disabling pain in adolescents with functional abdominal pain disorders (FAPDs).

Methods: We conducted a cross-sectional, nationwide study in a representative sample of 657 adolescents (51.1% girls, median age 15.0 [IQR 13.0-17.0] years) including 62 adolescents with FAPDs. We used study-specific questionnaires to explore school stressors, core outcome measures of pain and other somatic symptoms. We deployed multiple regression analyses to identify predictors of extremely low health-related quality of life (HRQOL).

Results: Amongst adolescents with FAPDs, school stressors and frequent harassment were significantly more prevalent; extraintestinal pain was reported by 54.8%, and 11.3% have reported continuous or daily pain. Significantly lower HRQOL, a higher number of missed school days and more frequent use of pain medication were identified. In the FAPD group, 14.5% (N = 9) adolescents reported extremely low HRQOL, which was associated with verbal harassment, multisite pain and higher frequency of pain on multivariate analysis.

Conclusions: Our results suggest that a portion of adolescents with FAPD may suffer from chronic disabling pain with extremely low HRQOL. These results may guide more accurate diagnostics of FAPDs.