1. Sign our petition calling on Cochrane to withdraw their review of Exercise Therapy for 'CFS'.
    Dismiss Notice
  2. Guest, the 'News in Brief' for the week beginning 3rd March 2025 is here.
    Dismiss Notice
  3. Welcome! Read the Core Purpose and Values of our forum.
    Dismiss Notice

Psycho-gastroenterological profile of an Italian population of children with disorders of gut-brain interaction: A case-control study 2025 Giorgio+

Discussion in 'Other psychosomatic news and research' started by Andy, Mar 11, 2025 at 9:22 AM.

Tags:
  1. Andy

    Andy Retired committee member

    Messages:
    23,557
    Location:
    Hampshire, UK
    BACKGROUND Disorders of gut-brain interaction (DGBI) are common, but knowledge about their physiopathology is still poor, nor valid tools have been used to evaluate them in childhood. AIM To develop a psycho-gastroenterological questionnaire (PGQ) to assess the psycho-gastroenterological profile and social characteristics of a pediatric population with and without DGBI.

    METHODS One hundred and nineteen Italian children (age 11-18) were included: 28 outpatient patients with DGBI (Rome IV criteria) and 91 healthy controls. They filled the PGQ, faces pain scale revised (FPS-R), Bristol stool chart, gastrointestinal symptoms rating scale, state-trait anxiety inventory, Toronto alexithymia scale 20, perceived self-efficacy in the management of negative emotions and expression of positive emotions (APEN-G, APEP-G), irritable bowel syndrome-quality of life questionnaire, school performances, tobacco use, early life events, degree of digitalization.

    RESULTS Compared to controls, patients had more medical examinations (35% of them went to the doctor more than five times), a higher school performance (23% vs 13%, P < 0.05), didn’t use tobacco (never vs 16%, P < 0.05), had early life events (28% vs 1% P < 0.05) and a higher percentage of pain classified as 4 in the FPS-R during the examination (14% vs 7%, P < 0.05).

    CONCLUSION Pediatric outpatients with DGBI had a higher prevalence of early life events, a lower quality of life, more medical examinations rising health care costs, lower anxiety levels.

    Key Words: Disorders of gut-brain interaction; Functional gastrointestinal disorders; Psycho-gastroenterological profile; Gut-brain axis; Rome IV criteria; Pediatric patients

    Core Tip: Little is known with respect to the presence of psychological issues in association with gastrointestinal problems among children and adolescents with disorders of gut-brain interaction. The psycho-gastroenterological questionnaire could be useful to better identify such issues to tailor a possible psychological and pharmacological treatment.

    Open access
     
    Andy, Mar 11, 2025 at 9:22 AM
    #1
    Utsikt, Hutan and Deanne NZ like this.
  2. Sean

    Sean Moderator Staff Member

    Messages:
    8,656
    Location:
    Australia
    Four of the 8 significant results tell us nothing about causal directions (lower quality of life, more medical examinations, rising health care costs, and higher pain scores). They could all be the consequences of undiagnosed or untreated physiopathology.

    One (higher prevalence of early life events) appears to be derived from retrospective recall, which is well known to be problematic, often reporting a greater effect size than methodologically superior prospective studies.

    Three showed better scores for patients (a higher school performance, much lower tobacco use, and lower anxiety levels – the sole psych health measure to report a difference).

    And apparently none of the other measures, including some mental health measures, reported any difference.

    I really don't see the justification for all the psycho-speculation fluff in this study.

    The main limit is the small sample considered.​

    No the main limit is the retrospective basis for the early life events. Take that problematic result away and you basically got nothing at all.
     
    Sean, Mar 11, 2025 at 10:51 AM
    #2
    NelliePledge, Arnie Pye, alktipping and 7 others like this.
  3. Utsikt

    Utsikt Senior Member (Voting Rights)

    Messages:
    1,139
    Location:
    Norway
    This has the same usefulness as a psycho-astrological profile.
     
    Utsikt, Mar 11, 2025 at 12:26 PM
    #3
    Sean, SNT Gatchaman, NelliePledge and 5 others like this.
  4. Hutan

    Hutan Moderator Staff Member

    Messages:
    31,363
    Location:
    Aotearoa New Zealand
    Great analysis @Sean.

    These people are doing harm, blundering about labelling gastrointestinal symptoms in children as being due to psychological factors.

    On one hand, they are suggesting that Disorders of Gut Brain Interaction are extremely common, 1 in 5 children. And yet, among 956 patients at a Pediatric Gastroenterology Outpatient Unit (already a highly selected sample), only 28 children were deemed to be suitable for this study and enrolled. The selection bias is therefore huge. Parents of children who believe in the concept of DGBI and who believe that their children have it are far more likely to allow their child to be enrolled.
    This study appears to have been done in 2017, and yet it is only being published now.
     
    Hutan, Mar 11, 2025 at 4:31 PM
    #4
    Sean, alktipping, Trish and 2 others like this.
  5. Hutan

    Hutan Moderator Staff Member

    Messages:
    31,363
    Location:
    Aotearoa New Zealand
    The control group appears to be very poorly matched.
    On sex: 64% of the cases were male; only 10% of the controls were male
    On age: mean age of the cases was 14 years; mean age of the controls was 16.5 years (this surely affecting cigarette smoking rates)

    On 'early life events', it seems that it wasn't just a question asked of the participants and their parents. There was a 'semi-structured interview', providing ample opportunities for the researcher's bias to be expressed as they fished for 'early life events'.
     
    Hutan, Mar 11, 2025 at 4:50 PM
    #5
    Sean, alktipping and Utsikt like this.
  6. Utsikt

    Utsikt Senior Member (Voting Rights)

    Messages:
    1,139
    Location:
    Norway
    Apparently, the journal has a peer review grading system! I have no idea how it works, but these were in the footnotes at the bottom of the page:

    Peer-review report’s classification
    Scientific Quality: Grade C, Grade C
    Novelty: Grade B, Grade C
    Creativity or Innovation: Grade B, Grade C Scientific Significance: Grade B, Grade C
     
    Utsikt, Mar 11, 2025 at 4:59 PM
    #6
    Sean, alktipping and Hutan like this.
  7. Hutan

    Hutan Moderator Staff Member

    Messages:
    31,363
    Location:
    Aotearoa New Zealand
    This paper is awful in just about every respect. Maybe I give them some admiration for actually publishing the null results for the tests such as anxiety.

    I think this is one where a complaint to the ethics committee could be warranted, to try to head off further work on young people by this group.
     
    Hutan, Mar 11, 2025 at 5:43 PM
    #7
    Sean and alktipping like this.
  8. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

    Messages:
    6,526
    Location:
    UK
    Me neither. But when people write about children trying to get off school in literature because the child feels unwell, they almost always say the child complains of a sore stomach. In my youth it was almost always assumed that the child was lying.
     
    Arnie Pye, Mar 11, 2025 at 11:43 PM
    #8
    Sean and Hutan like this.

Share This Page