Clinical Characterization of Juvenile Fibromyalgia in a Multi-Center Cohort of Adolescents Enrolled in the FIT Teens Trial 2022 Lynch-Jordan et al

Abstract

Objective
Juvenile 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.

Methods
Participants were 203 adolescents (12-17 years) who completed baseline assessments for the multi-site Fibromyalgia Integrative Training for Teens (FIT Teens) randomized control trial. Participants completed the Pain and Symptom Assessment Tool (PSAT), 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 ACR criteria for Fibromyalgia. Participants also completed self-report measures of pain intensity, functional impairment, and psychological functioning.

Results
Participants endorsed a median of 11 painful body sites (WPI) 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, gastroenterological, and psychological symptoms were frequently endorsed. WPI 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.

Conclusion
JFM 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.

Paywall, https://onlinelibrary.wiley.com/doi/10.1002/acr.25077

 

I don't know what the hell they could probably mean by the complete irrelevance of "how diffuse the pain is" or why it matters to anyone, but when all you do is BS like this, it fully explains this:

Clown around for decades, don't get surprised if you're a clown show.

 

"appears less important" is not the same as "complete irrelevance". Not that I think the study necessarily has value but it's better for any criticism to be accurate, rather than hyperbolic.

 

I don't see how "diffusion of pain" is of any relevance. I've never heard of anyone complaining not about their pain, but about how little or very diffuse it is. Just a weird thing to fixate on.