Quality of Life and Emotional Functioning in Youth With Chronic Migraine and Juvenile Fibromyalgia

Abstract

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 (e.g., headache, abdominal pain) with relatively small sample sizes. As a result, the similarities and differences in the impact of pain in sub-groups of children with chronic pain have not been closely examined. Objectives To compare pain characteristics, quality of life, and emotional functioning among youth with pediatric chronic migraine (CM) and juvenile fibromyalgia (JFM). Methods We combined data obtained during screening of patients for two relatively large intervention studies of youth (ages 10-18) 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; CDI), and anxiety symptoms (Adolescent Symptom Inventory-4 - Anxiety subscale) were completed by youth and their parent. A multivariate analysis of co-variance (MANCOVA) controlling for effects of age and gender was performed to examine differences in quality of life and emotional functioning between the CM and JFM groups. Results 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. Discussion Results indicate important differences in sub-groups of pediatric pain patients and point to the need for more intensive multidisciplinary intervention for JFM patients.

Musculoskeletal Pain, Self-reported Physical Function, and Quality of Life in the Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Cohort

“…Clinical depressive symptoms assessed by the Beck Depression Inventory–II were also considered as confounders in the regression analyses because pain and WRQOL are highly correlated with depressive symptoms. 38,39 The suggested total score of more than 17 was used as a conservative cut point for clinically elevated depressive symptoms. 40 …”

Personal and Contextual Factors Affecting the Functional Ability of Children and Adolescents with Chronic Pain

“…Sensation may be influenced by tissue injury and functional limitations imposed by disease processes such as limb immobilization. 7 Given the importance afforded to cognitions such as catastrophizing in the pain literature for children and adolescents, [17][18][19][20][21] cognition (patterns of thinking which create meaning directed toward goal achievement 22 ) has been included as an additional internal dimension for this review.…”

The Influence of Anxiety Reduction on Clinical Response to Pediatric Chronic Pain Rehabilitation

“…This scale has well-established validity [36][37][38] and is widely used as an outcome measure in pediatric research 39,40 and in pediatric pain. [41][42][43] For this study, the physical and psychosocial (combining emotional, social, and school functioning) subscales were used. In addition, 2 single-item self-report outcome measures were used to evaluate response to pain rehabilitation: (1) number of school days missed by the patient over the past month; and (2) pain severity rating in last 24 hours (0 to 10 numerical rating scale, with 10 indicating most pain).…”