Behavioral functioning and treatment adherence in pediatric eosinophilic gastrointestinal disorders

Pediatr Allergy Immunol. 2012 Aug;23(5):494-9. doi: 10.1111/j.1399-3038.2012.01297.x. Epub 2012 Mar 22.

Abstract

Objective: To examine behavioral predictors of treatment adherence in patients with eosinophilic gastrointestinal disorders (EGID).

Methods: Participants were 96 patients 2.5-18 yr of age with eosinophilic esophagitis or eosinophilic gastroenteritis and their caregivers (mother, father). We assessed maternal and paternal report of child/adolescent internalizing symptoms (e.g., anxiety, depression) and externalizing symptoms (e.g., aggression, anger) using the Behavior assessment system for children, 2nd edition (BASC-2). A multi-informant adherence assessment approach and an 80% cut point were used to classify patients as adherent or non-adherent.

Results: Sociodemographic predictors did not distinguish between adherent and non-adherent patients. Maternal report of internalizing symptoms significantly correlated with non-adherence (p < 0.001). Post hoc probing revealed a significant contribution of depression, with depressed patients being more likely (OR = 7.27; p < 0.05) to be non-adherent than non-depressed patients. Paternal report of internalizing and externalizing symptoms was not associated with non-adherence.

Conclusions: Maternal report of patient internalizing behavioral symptoms, particularly depression, is significantly associated with non-adherence in patients with EGID. These symptoms are potential risk factors and should be considered when assessing and treating non-adherence. Clinical care of patients with EGID should include routine screening for depression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Caregivers / statistics & numerical data*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Depression / complications*
  • Enteritis / complications
  • Enteritis / psychology*
  • Enteritis / therapy*
  • Eosinophilia / complications
  • Eosinophilia / psychology*
  • Eosinophilia / therapy*
  • Eosinophilic Esophagitis / complications
  • Eosinophilic Esophagitis / psychology*
  • Eosinophilic Esophagitis / therapy*
  • Female
  • Gastritis / complications
  • Gastritis / psychology*
  • Gastritis / therapy*
  • Humans
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data*
  • Risk Factors
  • United States
  • Young Adult

Supplementary concepts

  • Eosinophilic enteropathy