Anxiety, mood, and behavioral disorders among pediatric patients with juvenile fibromyalgia syndrome
Anxiety, mood, and behavioral disorders among pediatric patients with juvenile fibromyalgia syndrome
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DOI：
10.1097/ajp.0b013e31816d7d23
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发表时间：
2008-09-01
影响因子：
2.9
通讯作者：
Richards, Margaret M.
中科院分区：
文献类型：
--
作者：
Kashikar-Zuck, Susmita;Parkins, Irina S.;Richards, Margaret M.
背景资料：心境障碍和焦虑障碍是纤维肌痛综合征成人患者常见的精神疾病，但对纤维肌痛儿童患者是否普遍存在精神疾病知之甚少。目的：这项研究的主要目的是评估情绪，焦虑，青少年原发性纤维肌痛综合征（JPFS）儿童和青少年临床样本中的行为障碍并评估精神疾病与JPFS症状严重程度之间的关系。对儿童及其父母/主要照顾者进行了标准化的精神病学访谈，对76名诊断为JPFS的儿童和青少年进行了症状严重程度的测量，包括疼痛强度和医生总体评分结果：总共有67.1%的患者具有至少一个当前精神病诊断，71.5%具有至少一个终生DSM-IV（精神障碍诊断和统计手册-第四版）精神病诊断。最常见的精神病诊断是焦虑症（占JPFS患者的57.5%）。虽然情绪困难也很常见，但重度抑郁症的存在低于纤维肌痛综合征成年人的报告。对于目前患有焦虑症的患者，医生对功能的整体评估显着降低。有焦虑和无焦虑患者的疼痛程度无显著差异。讨论：在JPFS患者中，焦虑障碍的患病率似乎很高，焦虑障碍的存在与医生评定的功能较差相关。未来的研究应该探索早期焦虑症状是否可以预测长期功能。
Background: Mood and anxiety disorders are common psychiatric conditions among adult patients with fibromyalgia syndrome, but little is known about whether psychiatric disorders are prevalent among pediatric patients with fibromyalgia.Objective: The primary objective of this study was to assess the prevalence of mood, anxiety, and behavioral disorders in a clinical sample of children and adolescents with juvenile primary fibromyalgia syndrome (JPFS) and assess the relationship between psychiatric disorders and JPFS symptom severity.Methods: Standardized psychiatric interviews were conducted with children and their parents/primary caregivers, and measures of symptom severity including pain intensity and physician global ratings were obtained for 76 children and adolescents diagnosed with JPFS (ages 11 to 18 y) in pediatric rheumatology clinics at 4 hospitals in the Midwest.Results: A total of 67.1 % of patients had at least 1 current and 71.5% had at least 1 lifetime DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-fourth edition) psychiatric diagnosis. The most frequent psychiatric diagnosis was anxiety disorder (57.5% of JPFS patients). Although mood difficulties were also common, the presence of major depression was lower than has been reported for adults with fibromyalgia syndrome. Physicians' global assessment of functioning was significantly lower for patients with a current anxiety disorder. There were no significant differences in pain severity among patients with and without anxiety.. mood, or behavioral disorders.Discussion: There seems to be a high prevalence of anxiety disorders in patients with JPFS, and presence of anxiety disorder is associated with poorer physician-rated functioning. Future research should explore whether early anxiety symptoms are predictive of long-term functioning.