Psychopathology and Trauma Risk in Children with Intestinal Failure: A Critical Examination

The following is a summary of “Children with Intestinal Failure are at Risk for Psychopathology and Trauma,” published in the December 2023 issue of Pediatrics by Vlug, et al.

For a study, researchers sought to look at the mental health problems and severe physical stress in kids who have an intestine failure (IF) and find the risk factors that were linked to these problems. A two-center study was done from September 2019 to April 2022 with children with IF (ages 1.5 to 17) who were either on parenteral nutrition (PN) or had been taken off of it and were being treated by a multidisciplinary IF team. Part of the study was done during the COVID-19 pandemic. A semi-structured interview and approved surveys were used to examine children’s mental classifications and emotional (internalizing) and behavioral (externalizing) problems. 

A standardized questionnaire was used to measure severe medical stress. The problem scores were compared to the standard data. Linear regression models were used to find links between clinical factors and results. Out of 111 qualified children, 41 were included. Their median age was 8.9 years (IQR: 5.5–11.8), 54% were girls, and 73% were born before their due dates. The median time on PN was 17.3 months (IQR: 6.9–54.0), and 17 children (41%) were still on it. Only 14% of kids in the same age group as the kids in this study met the standards for at least one mental classification. One-third of the kids did. The most common ones were anxiety illnesses and attention deficit hyperactivity disorder. Children in school (n = 29, 6–17 years old) regularly reported having a lot more mental problems (P = 0.011), as did their parents (P < 0.001) and teachers (P = 0.004). 

No important changes were found between the standard data and the preschool children (n = 12, 1.5–5 years old). 19 children (46% of the total) said they had subclinical or severe mental problems. 14% of the kids had medical traumatic stress, and 22% had already gotten help for trauma in the past. Emotional troubles were linked to a lower quality of life in terms of digestion but not to PN length. Findings: Kids with IF, especially school-aged kids, are more likely to have mental health issues. This is shown by the high number of kids who get psychotherapy, have emotional problems, and are classified by psychiatrists.


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