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Maternal Psychopathology and Psychomotor Development of Children With GERD

Karacetin, Gul*; Demir, Turkay*; Erkan, Tulay; Cokugras, Fugen Cullu; Sonmez, Burcin Alsancak*

Journal of Pediatric Gastroenterology and Nutrition: October 2011 - Volume 53 - Issue 4 - p 380–385
doi: 10.1097/MPG.0b013e3182298caa
Original Articles: Gastroenterology

Objectives: The relation between gastroesophageal reflux disease (GERD) and maternal psychopathology as well as the role of impairments in mother–child interactions in the perpetuation of feeding problems in children with GERD was previously implicated but not confirmed. The present study aimed to study the relation between maternal psychopathology and feeding problems in children with GERD and the effects of GERD on the psychomotor development of children.

Subjects and Methods: The case group included 39 children with GERD and their mothers and the comparison group included 39 healthy children and their mothers. The groups were matched for age, gestational age, socioeconomic status, and sex. Scales used for the psychiatric assessment of mothers were the Beck Anxiety Inventory, Hamilton Rating Scale for Depression, Eating Attitudes Test, and Experiences in Close Relationships-Revised. The children's developmental levels were assessed by the Brunet-Lezine Revised test.

Results: Maternal Beck Anxiety Inventory, Hamilton Rating Scale for Depression, Eating Attitudes Test, and Experiences in Close Relationships-Revised scores were significantly higher in the case group. Forced feeding and maternal thoughts of the child's feeding as insufficient were associated with a high level of maternal attachment-related anxiety and avoidance. Children with GERD had significantly lower Brunet-Lezine-Revised scores.

Conclusions: Maternal psychopathology, especially insecure attachment, may play a role in the feeding problems in children with GERD. Children with GERD should be examined for maternal psychopathology and feeding problems so that maladaptive feeding behaviors can receive appropriate intervention before the development of negative reinforcement to feeding. The psychomotor development of children should be kept in mind.

*Department of Child and Adolescent Psychiatry

Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey.

Address correspondence and reprint requests to Gul Karacetin, MD, Department of Child and Adolescent Psychiatry, Corum State Hospital, Corum, Turkey (e-mail:

Received 13 October, 2010

Accepted 5 May, 2011

The preliminary findings of this study were presented at the first Helmut Remschmidt Research Seminar, Istanbul, Turkey, December 2–7, 2007.

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN