Anxiety, mood, and behavioral disorders among pediatric patients with juvenile fibromyalgia syndrome

Clin J Pain. 2008 Sep;24(7):620-6.

Anxiety, mood, and behavioral disorders among pediatric patients with juvenile fibromyalgia syndrome.

Kashikar-Zuck S, Parkins IS, Graham TB, Lynch AM, Passo M, Johnston M, Schikler KN, Hashkes PJ, Banez G, Richards MM. Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA. This email address is being protected from spambots. You need JavaScript enabled to view it.

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.

PMID: 18716501 [PubMed - in process]