Clinical Characterization of Juvenile Fibromyalgia in a Multicenter Cohort of Adolescents Enrolled in a Randomized Clinical Trial.
Clinical Characterization of Juvenile Fibromyalgia in a Multicenter Cohort of Adolescents Enrolled in a Randomized Clinical Trial.
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参加随机临床试验的多中心青少年队列中青少年纤维肌痛的临床特征。
DOI：
10.1002/acr.25077
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发表时间：
2023
影响因子：
4.7
通讯作者：
Fibromy
中科院分区：
文献类型：
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作者：
Lynch-Jordan,AnneM;Connelly,Mark;Guite,JessicaW;King,Christopher;Goldstein-Leever,Alana;Logan,DeirdreE;Nelson,Sarah;Stinson,JenniferN;Ting,TracyV;Wakefield,EmilyO;Williams,AmyE;Williams,SaraE;Kashikar-Zuck,Susmita;Fibromy
青少年纤维肌痛（JFM）是一种复杂的慢性疼痛状况，目前仍知之甚少。这项研究的目的是扩大JFM的临床表征在一个大的代表性样本的青少年与JFM和确定心理因素，预测疼痛interference.MethodsParticipants是203青少年（年龄12-17岁）谁完成了基线评估的多部位纤维肌痛综合训练青少年（FIT青少年）随机对照试验。参与者完成了疼痛和症状评估工具，其中包括广泛疼痛指数（WPI; 0-18个疼痛部位）和相关躯体症状的症状严重程度检查表（SS; 0-12），基于2010年美国风湿病学会纤维肌痛标准。参与者还完成了自我报告的措施，疼痛强度，功能障碍，和心理functioning.ResultsParticipants认可的中位数为11疼痛的身体部位（WPI评分），并有一个中位数为9 SS评分。疲劳和非恢复性睡眠是突出的特征，85%的参与者将其评为中度至重度。此外，神经系统、自主神经系统、胃肠系统和心理症状也经常被认可。WPI评分与疼痛强度和灾难化显著相关，而SS评分与疼痛强度和身体和心理功能的所有领域相关。抑郁症状，疲劳和疼痛catastrophizing预测的严重程度pain impairment.ConclusionJFM的特点是慢性广泛疼痛与疲劳，nonrestorative睡眠，和其他躯体症状。然而，弥漫性疼痛的分布似乎不如其他躯体和心理因素对临床结局和损伤的重要性，这突出了需要更广泛的方法来评估和治疗JFM。
ObjectiveJuvenile fibromyalgia (JFM) is a complex chronic pain condition that remains poorly understood. The study aimed to expand the clinical characterization of JFM in a large representative sample of adolescents with JFM and identify psychological factors that predict pain interference.MethodsParticipants were 203 adolescents (ages 12–17 years) who completed baseline assessments for the multisite Fibromyalgia Integrative Training for Teens (FIT Teens) randomized control trial. Participants completed the Pain and Symptom Assessment Tool, which includes a Widespread Pain Index (WPI; 0–18 pain locations) and Symptom Severity checklist of associated somatic symptoms (SS; 0–12) based on the 2010 American College of Rheumatology criteria for fibromyalgia. Participants also completed self‐report measures of pain intensity, functional impairment, and psychological functioning.ResultsParticipants endorsed a median of 11 painful body sites (WPI score) and had a median SS score of 9. Fatigue and nonrestorative sleep were prominent features and rated as moderate to severe by 85% of participants. Additionally, neurologic, autonomic, gastroenterologic, and psychological symptoms were frequently endorsed. The WPI score was significantly correlated with pain intensity and catastrophizing, while SS scores were associated with pain intensity and all domains of physical and psychological functioning. Depressive symptoms, fatigue, and pain catastrophizing predicted severity of pain impairment.ConclusionJFM is characterized by chronic widespread pain with fatigue, nonrestorative sleep, and other somatic symptoms. However, how diffusely pain is distributed appears less important to clinical outcomes and impairment than other somatic and psychological factors, highlighting the need for a broader approach to the assessment and treatment of JFM.