Kashikar-Zuck Susmita, Lynch Anne M, Slater Shalonda, Graham T Brent, Swain Nicole F, Noll Robert B
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
Arthritis Rheum. 2008 Oct 15;59(10):1392-8. doi: 10.1002/art.24099.
Family factors and emotional functioning can play an important role in the ability of adolescents with juvenile primary fibromyalgia syndrome (JPFS) to cope with their condition and function in their everyday lives. The primary objectives of this study were to determine 1) whether adolescents with JPFS and their caregivers differed from healthy age-matched comparison peers and their caregivers in terms of emotional distress and functional impairment; 2) whether there were any differences in the family environment of adolescents with JPFS compared with healthy comparison peers; and 3) which individual-, caregiver-, and family-level variables were associated with functional impairment in adolescents with JPFS.
Participants were 47 adolescents with JPFS recruited from a pediatric rheumatology clinic and 46 comparison peers without chronic illness matched for age, sex, and race. Participants and their caregivers (all mothers) completed a battery of standardized measures administered in their homes.
Adolescents with JPFS had greater internalizing and externalizing symptoms than healthy comparison peers. Mothers of adolescents with JPFS reported twice as many pain conditions and significantly greater depressive symptoms than mothers of comparison peers. The JPFS group also had poorer overall family functioning and more conflicted family relationships. In adolescents with JPFS, maternal pain history was associated with significantly higher functional impairment.
Increased distress and chronic pain are evident in families of adolescents with JPFS, and family relationships are also impacted. Implications for child functional impairment and the need for inclusion of caregivers in treatment are discussed.
家庭因素和情绪功能在患有青少年原发性纤维肌痛综合征(JPFS)的青少年应对自身状况及日常生活功能方面可能发挥重要作用。本研究的主要目的是确定:1)患有JPFS的青少年及其照顾者在情绪困扰和功能损害方面是否与年龄匹配的健康对照同龄人及其照顾者存在差异;2)与健康对照同龄人相比,患有JPFS的青少年的家庭环境是否存在差异;3)哪些个体、照顾者和家庭层面的变量与患有JPFS的青少年的功能损害相关。
研究对象为47名从儿科风湿病诊所招募的患有JPFS的青少年以及46名年龄、性别和种族匹配的无慢性疾病的对照同龄人。参与者及其照顾者(均为母亲)在家中完成了一系列标准化测量。
患有JPFS的青少年比健康对照同龄人有更多的内化和外化症状。患有JPFS的青少年的母亲报告的疼痛状况是对照同龄人母亲的两倍,抑郁症状也明显更严重。JPFS组的整体家庭功能也较差,家庭关系更冲突。在患有JPFS的青少年中,母亲的疼痛史与功能损害显著更高相关。
患有JPFS的青少年家庭中明显存在更多困扰和慢性疼痛,家庭关系也受到影响。讨论了对儿童功能损害的影响以及在治疗中纳入照顾者的必要性。