Divisions of *Behavioral Medicine and Clinical Psychology ‡Neurology §Pediatric Rheumatology, Cincinnati Children's Hospital Medical Center †Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH.
Clin J Pain. 2013 Dec;29(12):1066-72. doi: 10.1097/AJP.0b013e3182850544.
Chronic pain in children is associated with significant negative impact on social, emotional, and school functioning. Previous studies on the impact of pain on children's functioning have primarily used mixed samples of pain conditions or single pain conditions (eg, headache and abdominal pain) with relatively small sample sizes. As a result, the similarities and differences in the impact of pain in subgroups of children with chronic pain have not been closely examined.
To compare pain characteristics, quality of life, and emotional functioning among youth with pediatric chronic migraine (CM) and juvenile fibromyalgia (JFM).
We combined data obtained during screening of patients for 2 relatively large intervention studies of youth (age range, 10 to 18 y) with CM (N=153) and JFM (N=151). Measures of pain intensity, quality of life (Pediatric Quality of Life; PedsQL, child and parent-proxy), depressive symptoms (Children's Depression Inventory), and anxiety symptoms (Adolescent Symptom Inventory-4-Anxiety subscale) were completed by youth and their parent. A multivariate analysis of covariance controlling for effects of age and sex was performed to examine differences in quality of life and emotional functioning between the CM and JFM groups.
Youth with JFM had significantly higher anxiety and depressive symptoms, and lower quality of life in all domains. Among children with CM, overall functioning was higher but school functioning was a specific area of concern.
Results indicate important differences in subgroups of pediatric pain patients and point to the need for more intensive multidisciplinary intervention for JFM patients.
儿童慢性疼痛会对社交、情感和学业功能产生重大负面影响。先前关于疼痛对儿童功能影响的研究主要使用混合的疼痛状况样本或单一疼痛状况（如头痛和腹痛），且样本量相对较小。因此，慢性疼痛亚组儿童疼痛的相似性和差异性尚未得到密切检查。
比较患有儿科慢性偏头痛（CM）和青少年纤维肌痛（JFM）的青少年的疼痛特征、生活质量和情绪功能。
我们结合了对 2 项相对较大的青少年干预研究（年龄范围 10 至 18 岁）患者进行筛选期间获得的数据，这些研究包括 CM（N=153）和 JFM（N=151）。疼痛强度、生活质量（儿科生活质量量表；PedsQL，儿童和家长代理）、抑郁症状（儿童抑郁量表）和焦虑症状（青少年症状清单-4-焦虑分量表）由青少年及其家长完成。采用多元协方差分析（控制年龄和性别影响），比较 CM 和 JFM 组在生活质量和情绪功能方面的差异。
JFM 组的青少年焦虑和抑郁症状明显更高，所有领域的生活质量均较低。在患有 CM 的儿童中，整体功能较高，但学业功能是一个特别关注的领域。
结果表明儿科疼痛患者亚组存在重要差异，需要对 JFM 患者进行更强化的多学科干预。
