585 - Assessing Depression in Pediatric Patients Presenting to the Emergency Department with Abdominal Pain

Poster Number: 585
Publication Number: 585.1967

Background: Prior research conducted in outpatient clinic settings has demonstrated a link between high levels of depression and impaired outcomes in youth with abdominal pain. Although abdominal pain is one of the most common complaints in the pediatric emergency department (PED), there is a scarcity of data on the prevalence of depression in this population.

Objective: This study assessed depressive symptoms in youth presenting to a PED with abdominal pain and examined associations between depression and pain-related impairment.

Design/Methods: This cross-sectional study included youth 8-17 years old (Mage=12.88±2.87), presenting to a PED with abdominal pain. Exclusion criteria included an Emergency Severity Index of 1, having a primary psychiatric complaint, or screening positive for suicide risk during triage (via Ask Suicide-Screening Questionnaire). Participants completed demographics, pain history, the Patient Health Questionnaire for depression (PHQ-9A), and the PROMIS Pain Interference Scale. Depression was defined as a PHQ score >10 and recent self-harm ideation was indicated by >1 on PHQ item 9. Mean difference and logistic regression analyses were conducted.

Results: Among 271 participants, 25.8% reported depression, and 11.4% endorsed recent self-harm ideation. Screening positive for depression was associated with reporting pain for >1 month (X2=4.08, p=0.044), Latinx ethnicity (X2=3.98, p=0.046), and higher pain-related impairment (t=-5.68, p< 0.001). In multivariable regression analyses, only pain-related impairment was significantly associated with the likelihood of reporting depression (OR=1.10, p< 0.001). Youth endorsing self-harm ideation also reported higher pain-related impairment (t =-3.57 p< 0.001).

Conclusion(s): Approximately 25% of youth presenting to the PED with abdominal pain screened positive for depression and 11.4% endorsed self-harm ideation, after screening negative for self-harm risk at ED triage. Results highlight potential mental health concerns and pain-related impairment in this patient population and underscore the need to reevaluate mental health screening in the PED. Early identification of high pain-related impairment and depression, including self-harm ideation, may improve outcomes and better inform interventions for pediatric patients presenting to the PED with abdominal pain and mental health challenges.

Funding: National Institutes of Health, National Institute for Child Health and Human Development