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Cited by 135Fibromyalgia and Chronic Fatigue Syndrome ResearchAutoimmune and Inflammatory Disorders ResearchPediatric Pain Management Techniques

Long-Term Outcomes of Adolescents With Juvenile-Onset Fibromyalgia in Early Adulthood

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Kashikar-Zuck, Susmita, Cunningham, Natoshia, Sil, Soumitri, Bromberg, Maggie H., Lynch-Jordan, Anne M., Strotman, Daniel, Peugh, James, Noll, Jennie +4 more·2014·Pediatrics
DOI 10.1542/peds.2013-2220PMC PMC3934334
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Abstract

OBJECTIVE: This prospective longitudinal study examined the long-term physical and psychosocial outcomes of adolescents with juvenile-onset fibromyalgia (JFM), compared with healthy control subjects, into early adulthood. METHODS: Adolescent patients with JFM initially seen at a pediatric rheumatology clinic (n = 94) and age- and gender-matched healthy control subjects (n = 33) completed online measures of demographic characteristics, pain, physical functioning, mood symptoms, and health care utilization at ∼6 years’ follow-up (mean age: 21 years). A standard in-person tender-point examination was conducted. RESULTS: Patients with JFM had significantly higher pain (P < .001), poorer physical function (P < .001), greater anxiety (P < .001) and depressive symptoms (P < .001), and more medical visits (P < .001)than control subjects. The majority (>80%) of JFM patients continued to experience fibromyalgia symptoms into early adulthood, and 51.1% of the JFM sample met American College of Rheumatology criteria for adult fibromyalgia at follow-up. Patients with JFM were more likely than control subjects to be married and less likely to obtain a college education. CONCLUSIONS: Adolescent patients with JFM have a high likelihood of continued fibromyalgia symptoms into young adulthood. Those who met criteria for fibromyalgia in adulthood exhibited the highest levels of physical and emotional impairment. Emerging differences in educational attainment and marital status were also found in the JFM group. JFM is likely to be a long-term condition for many patients, and this study for the first time describes the wide-ranging impact of JFM on a variety of physical and psychosocial outcomes that seem to diverge from their same-age peers.

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Crossref · 10.1542/peds.2013-2220

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  • FSS symptoms frequently sustain into adulthood, carrying a significant risk of long-term impairment, reduced probability of obtaining higher education and high use of health care costs.

    “Frequently, symptoms sustain into adulthood, carrying a significant risk of long-term impairment, reduced probability of obtaining a higher education and a high use of health care costs [9–13].”

    From Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: A pilot study (2020) · cites this paper as [9]

    The Discussion (p. 6) reports that more than 80% of adolescents treated for juvenile-onset fibromyalgia continued to have symptoms in early adulthood, with impaired functioning and greater health care use than healthy peers. The abstract (p. 1) also reports lower college attainment. The study concerns juvenile-onset fibromyalgia rather than FSS generally, and it measures health care utilization, not costs. (LLM, conf=0.88)

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  • Adolescents with FSS are less likely to obtain a college education.

    “and are less likely to obtain a college education.9”

    From Comparing group-based acceptance and commitment therapy (ACT) with enhanced usual care for adolescents with functional somatic syndromes: A study protocol for a randomised trial (2016) · cites this paper as [9]

    The Discussion (p. 7) says healthy controls were more likely than adolescents with juvenile-onset fibromyalgia (JFM) to attend college, and the education table (p. 6) shows a lower proportion of JFM participants in the 'some college/bachelor’s/graduate degree' category. The study concerns JFM specifically, not adolescents with functional somatic symptoms (FSS) generally; it also does not establish that participants were less likely to complete a college degree. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • A substantial proportion of adolescents with FSS show continuity of functional symptoms into adulthood.

    “A substantial proportion show continuity of functional symptoms into adulthood9–11”

    From Comparing group-based acceptance and commitment therapy (ACT) with enhanced usual care for adolescents with functional somatic syndromes: A study protocol for a randomised trial (2016) · cites this paper as [9]

    The Discussion (p. 6) reports that more than 80% of adolescents with juvenile-onset fibromyalgia seen in a pediatric specialty setting continued to have symptoms into young adulthood. This supports continuity for that group, but the claim extends the finding to adolescents with functional somatic symptoms (FSS) more broadly. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • 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.

    “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 [6]

  • Youth with JPFS often are likely to have comorbid symptoms of anxiety and depression, which can further augment pain perception and problems with functioning and quality of life.

    “Youth with JPFS often are likely to have comorbid symptoms of anxiety and depression, which can further augment pain perception and problems with functioning and quality of life [6].”

    From Pain, functional disability, and their Association in Juvenile Fibromyalgia Compared to other pediatric rheumatic diseases (2019) · cites this paper as [6]

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3 of the 51 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [3]3. Gerloni V, Ghirardini M, Fantini F. Assessment of nonarticular tenderness and prevalence of primary fi bromyalgia syndrome in healthy Italian schoolchildren. Arthritis Rheum . 1998;41(9):1405

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Authors
Kashikar-Zuck, S., Cunningham, N., Sil, S., Bromberg, M. H., Lynch-Jordan, A. M., Strotman, D., Peugh, J., Noll, J., Ting, T. V., Powers, S. W., Lovell, D. J., & Arnold, L. M.
Affiliations
  • Divisions of Behavioral Medicine and Clinical Psychology and
  • Pennsylvania State University (US)
  • Cincinnati Children's Hospital Medical Center (US)
  • University of Cincinnati (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2014-03-01
Volume
133
Issue
3
Pages
e592-e600
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2013-2220
PMC
PMC3934334
OpenAlex
W2044719167
Cited by
135
References
51
Citations by year
2026: 4 · 2025: 13 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 21 · 2020: 11 · 2019: 9 · 2018: 10 · 2017: 12 · 2016: 15 · 2015: 11 · 2014: 5
FWCI
10.94
Type
journal article
Language
en
Open access
Locations
  • PEDIATRICS (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (UL1TR001425)
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR054842, K24AR056687)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Hematology › Autoimmune and Inflammatory Disorders Research
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
fibromyalgia, adolescents, early adulthood, long-term outcomes, chronic pain, physical function, anxiety, depressive symptoms, health care utilization, educational attainment, marital status, transition to adult care
MeSH terms
Adolescent, Age Factors, Child, Depression, Female, Fibromyalgia, Follow-Up Studies, Humans, Male, Pain Measurement, Prospective Studies, Socioeconomic Factors, Time Factors, Cohort Studies, Treatment Outcome, Young Adult

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