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Long-term outcomes of adolescents with juvenile-onset fibromyalgia into adulthood and impact of depressive symptoms on functioning over time
Open accessAbstract
Juvenile-onset fibromyalgia (JFM) is typically diagnosed in adolescence and characterized by widespread pain and marked functional impairment. The long-term impact of JFM into adulthood is poorly understood. The objectives of this study were to describe physical and psychosocial outcomes of youth diagnosed with JFM in early adulthood (∼8-year follow-up), examine longitudinal trajectories of pain and depressive symptoms from adolescence to young adulthood, and examine the impact of pain and depressive symptoms on physical functioning over time. Participants were 97 youth with JFM enrolled in a prospective longitudinal study in which pain symptoms, and physical and psychosocial functioning were assessed at 4 time points over approximately 8 years. At the time 4 follow-up (M age = 24.2 years), the majority continued to suffer from pain and impairment in physical, social, and psychological domains. However, trajectories of pain and emotional symptoms showed varying patterns. Longitudinal analysis using growth mixture modeling revealed 2 pain trajectories (Steady Improvement and Rapid Rebounding Improvement), whereas depressive symptoms followed 3 distinct trajectories (Low-Stable, Improving, and Worsening). Membership in the Worsening Depressive symptoms group was associated with poorer physical functioning over time (P < 0.001) compared with the Low-Stable and Improving groups. This study offers evidence that although JFM symptoms persist for most individuals, pain severity tends to decrease over time. However, depressive symptoms follow distinct trajectories that indicate subgroups of JFM. In particular, JFM patients with worsening depressive symptoms showed decreasing physical functioning and may require more intensive and consistent intervention to prevent long-term disability.
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“In at least a subset of youth with JPFS, pain is associated with significant and enduring impairment in the ability to participate in usual activities and maintain positive well-being [4–7].”
From Pain, functional disability, and their Association in Juvenile Fibromyalgia Compared to other pediatric rheumatic diseases (2019) · cites this paper as [7]
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Metadata
- Authors
- Kashikar-Zuck, S., Cunningham, N., Peugh, J., Black, W. R., Nelson, S., Lynch-Jordan, A. M., Pfeiffer, M., Tran, S. T., Ting, T. V., Arnold, L. M., Carle, A., Noll, J., Powers, S. W., & Lovell, D. J.
- Affiliations
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Cincinnati Children's Hospital Medical Center (US)
- Boston Children's Hospital (US)
- DePaul University (US)
- University of Cincinnati (US)
- Pennsylvania State University (US)
- ORCID
- Venue
- Pain
- Published
- 2018-10-16
- Volume
- 160
- Issue
- 2
- Pages
- 433-441
- ISSN
- 0304-3959 (ISSN-L)
- 1872-6623
- PMC
- PMC6344278
- OpenAlex
- W2897031396
- Cited by
- 72
- References
- 51
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 8 · 2023: 11 · 2022: 11 · 2021: 18 · 2020: 6 · 2019: 3
- FWCI
- 5.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR054842, K24AR056687)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- long-term outcomes, depressive symptoms, pain trajectories, physical function, psychosocial functioning, early adulthood, growth mixture modeling, chronic widespread pain, disability
- MeSH terms
- Adolescent, Child, Depression, Female, Fibromyalgia, Humans, Male, Pain, Pain Measurement, Patient Acceptance of Health Care, Psychiatric Status Rating Scales, Cohort Studies, Exercise, Age of Onset, Disease Progression, Young Adult
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