Ali Ather, Weiss Theresa R, Dutton Anne, McKee Douglas, Jones Kim D, Kashikar-Zuck Susmita, Silverman Wendy K, Shapiro Eugene D
Department of Pediatrics; Department of Medicine.
Department of Pediatrics.
J Pediatr. 2017 Apr;183:184-190. doi: 10.1016/j.jpeds.2016.12.053. Epub 2017 Jan 12.
To assess the feasibility of a mindfulness-based stress reduction (MBSR) program for adolescents with widespread chronic pain and other functional somatic symptoms and to make preliminary assessments of its clinical utility.
Three cohorts of subjects completed an 8-week MBSR program. Child- and parent-completed measures were collected at baseline and 8 and 12 weeks later. Measures included the Functional Disability Inventory (FDI), the Fibromyalgia/Symptom Impact Questionnaire-Revised (FIQR/SIQR), the Pediatric Quality of Life Inventory, the Multidimensional Anxiety Scale (MASC2), and the Perceived Stress Scale. Subjects and parents were interviewed following the program to assess feasibility.
Fifteen of 18 subjects (83%) completed the 8-week program. No adverse events occurred. Compared with baseline scores, significant changes were found in mean scores on the FDI (33% improvement, P = .026), FIQR/SIQR (26% improvement, P = .03), and MASC2 (child: 12% improvement, P = .02; parent report: 17% improvement, P = .03) at 8 weeks. MASC2 scores (child and parent) and Perceived Stress Scale scores were significantly improved at 12 weeks. More time spent doing home practice was associated with better outcomes in the FDI and FIQR/SIQR (44% and 26% improvement, respectively). Qualitative interviews indicated that subjects and parents reported social support as a benefit of the MBSR class, as well as a positive impact of MBSR on activities of daily living, and on pain and anxiety.
MBSR is a feasible and acceptable intervention in adolescents with functional somatic syndromes and has preliminary evidence for improving functional disability, symptom impact, and anxiety, with consistency between parent and child measures.
ClinicalTrials.gov: NCT02190474.
评估基于正念减压（MBSR）项目对患有广泛性慢性疼痛和其他功能性躯体症状青少年的可行性，并对其临床效用进行初步评估。
三组受试者完成了为期8周的MBSR项目。在基线、8周和12周后收集了儿童和家长完成的测量指标。测量指标包括功能残疾量表（FDI）、纤维肌痛/症状影响问卷修订版（FIQR/SIQR）、儿童生活质量量表、多维焦虑量表（MASC2）和感知压力量表。项目结束后对受试者和家长进行访谈以评估可行性。
18名受试者中有15名（83%）完成了为期8周的项目。未发生不良事件。与基线分数相比，8周时FDI平均分数有显著变化（改善33%，P = 0.026）、FIQR/SIQR（改善26%，P = 0.03）和MASC2（儿童：改善12%，P = 0.02；家长报告：改善17%，P = 0.03）。12周时MASC2分数（儿童和家长）和感知压力量表分数显著改善。在家练习时间越长，FDI和FIQR/SIQR的结果越好（分别改善44%和26%）。定性访谈表明，受试者和家长报告称社会支持是MBSR课程的一个益处，以及MBSR对日常生活活动、疼痛和焦虑有积极影响。
MBSR对患有功能性躯体综合征的青少年是一种可行且可接受的干预措施，并有初步证据表明其可改善功能残疾、症状影响和焦虑，且家长和儿童测量结果具有一致性。
ClinicalTrials.gov：NCT02190474。
