Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Rheumatology (Oxford). 2010 Nov;49(11):2204-9. doi: 10.1093/rheumatology/keq254. Epub 2010 Aug 5.
Currently, there are no prospective studies exploring the prognosis of patients with juvenile primary FM syndrome (JPFS) or their physical, emotional and social outcomes as they enter the early adult years. The primary objective of this study was to assess long-term outcomes of a paediatric sample of clinically referred JPFS patients and their matched healthy controls.
Participants were 48 youths (current mean age = 19 years) diagnosed with JPFS in childhood or adolescence and 43 healthy controls matched in age, gender and race. The average length of follow-up was 3.67 years (range 2-6 years). Participants completed online (web-based) self-report questionnaires about current pain and physical symptoms, health status, anxiety, depressive symptoms and current and past treatments.
Results showed that 62.5% of participants in the JPFS group continued to experience widespread pain and 60.4% reported having all the cardinal features of FM syndrome (including widespread pain, poor sleep and fatigue) at follow-up. The JPFS group reported significantly lower scores on all measures of health status and physical functioning compared with healthy controls and significantly greater symptoms of anxiety and depression.
The results of this controlled follow-up study demonstrate that symptoms of FM appear to be chronic in a majority of clinically referred JPFS patients and the associated physical and emotional impairment can also be persistent. Implications for treatment and the need for further prospective longitudinal studies are discussed.
目前尚无前瞻性研究探讨青少年原发性纤维肌痛综合征(JPFS)患者的预后及其进入成年早期后的身体、情绪和社会结局。本研究的主要目的是评估临床确诊的 JPFS 患儿样本及其匹配的健康对照者的长期结局。
参与者为 48 名青少年(目前的平均年龄为 19 岁),他们在儿童或青少年时期被诊断为 JPFS,以及 43 名年龄、性别和种族匹配的健康对照者。平均随访时间为 3.67 年(范围 2-6 年)。参与者通过在线(基于网络)自我报告问卷完成有关当前疼痛和身体症状、健康状况、焦虑、抑郁症状以及当前和过去治疗的情况。
结果表明,JPFS 组中有 62.5%的参与者持续经历广泛的疼痛,60.4%的人在随访时报告有纤维肌痛综合征的所有主要特征(包括广泛疼痛、睡眠不佳和疲劳)。与健康对照组相比,JPFS 组在所有健康状况和身体功能测量方面的得分明显较低,焦虑和抑郁症状明显更严重。
这项对照随访研究的结果表明,在大多数临床确诊的 JPFS 患者中,FM 症状似乎是慢性的,相关的身体和情绪损伤也可能持续存在。讨论了治疗的意义以及进一步进行前瞻性纵向研究的必要性。