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ECPB 2015, 72(4): 103–109
https://doi.org/10.25040/ecpb2015.04.103
Assisting a doctor

Asthenic syndrome accompanying functional gastroduodenal pathology in children

LYCHKOVSKA O.
Abstract

Asthenic syndrome (AS) is one of the most common problem in the medical practice of physicians of any speciality, very often it is accompanied with psychosomatic disorders. AS may precede the development of physical symptoms or even dominate in the clinic of psychosomatic diseases, and often remain unnoticed by doctors. However, these comorbid mental and emotional disorders significantly reduce the quality of life of patients with psychosomatic disorders, even more than most somatic symptoms, and require early diagnosis and treatment.

Current study aimed at investigation of the clinical features of AS accompanying functional dyspepsia in children and efficiency of implementation of psychotherapy into the complex treatment.

The study involved 83 children with functional dyspepsia – a basic group (BG) – and 45 children without any systemic and organ pathology – group of control (CG). To evaluate the effectiveness of psychotherapy BG was divided into 2 groups: BG1 – 45 children who received psychotherapeutic treatment and BG2 – 38 children whose parents refused psychotherapy. For the diagnosis of asthenic syndrome a chart with a list of the most common symptoms was elaborated, the severity of which was assessed by Likert scale. The level of anxiety in children was determined by the CMAS method.

Results and discussion. Manifestation of AS was determined in 64 (77,0 %) patients from BG and in 7 (15,6 %) children from CG. Representatives of both groups demonstrate dominantly ″genuine″ asthenia (lethargy, weakness, constant fatigue, low capacity for work, absent-mindedness, negative mood, apathy). However, studies of the BG revealed more significant occurrence of ″anxious″ asthenia (irritability, anxiety, emotional lability, tearfulness, hypersensitivity). Thus, semiotic of AS, accompanying functional dyspepsia was closer to the signs of depressive syndrome.

The level of obvious anxiety was greater with a high degree of reliability (p = 0,001) among children from the BG comparing with those from the CG. A strong positive correlative relationship between the level of anxiety and severity of asthenic syndrome (r = 0,77; p = 0,001) was revealed. The high degree of anxiety in patients with chronic gastroduodenal diseases leads to overstress of regulatory mechanisms, manifested by vegetative disorders; later this leads to the depletion of the adaptive abilities of the organism, to the development and progression of the asthenia symptoms. The implementation of the psychotherapy into the complex therapy of functional dyspepsia in children has a positive effect on the manifestation of gastroduodenal diseases – it promotes early disappearing of clinical symptoms of the underlying problem, prevents early ″clinic recurrence″, reduce the level of anxiety and fatigue.

Thus, the functional gastroduodenal pathology in children is accompanied by the formation of asthenic syndrome with severe signs of ″anxious″ fatigue that gives grounds to consider it as the equivalent of a depressive syndrome in adults in the process of formation. The degree of asthenic syndrome is a strong positive correlation in relation to levels of anxiety. Implementation of the psychotherapy into the complex therapy of functional dyspepsia in children has a positive effect on the manifestation of functional gastroduodenal diseases – it prevents early ″clinic recurrence″, reduces the level of anxiety and fatigue.

Keywords: asthenic syndrome, functional dyspepsia in children

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