Characteristics of highly impaired children with severe chronic pain: a 5-year retrospective study on 2249 pediatric pain patients

BMC Pediatrics

Markus Blankenburg¹  Christine Wamsler¹  Bettina Hübner-Möhler¹  Adrian Meyer¹  Michael Dobe¹  Uta Rohr¹  Carola Hasan¹  Tanja Hechler¹  Julia Wager¹  Boris Zernikow¹ 

[1] German Paediatric Pain Centre and Vodafone Foundation Chair of Children’s Pain Therapy and Paediatric Palliative Care, Children’s and Adolescents’ Hospital, Datteln, Witten/Herdecke University, Faculty of Health – School of Medicine, Dr.-Friedrich-Steiner Str. 5, Datteln, 45711, Germany

关键词: Pediatric;    Risk factors;    Impairment;    Chronic pain;    Children;   

Others  :  1170792
DOI  :  10.1186/1471-2431-12-54

 received in 2011-12-07, accepted in 2012-05-16,  发布年份 2012

【 摘 要 】

Background

Prevalence of pain as a recurrent symptom in children is known to be high, but little is known about children with high impairment from chronic pain seeking specialized treatment. The purpose of this study was the precise description of children with high impairment from chronic pain referred to the German Paediatric Pain Centre over a 5-year period.

Methods

Demographic variables, pain characteristics and psychometric measures were assessed at the first evaluation. Subgroup analysis for sex, age and pain location was conducted and multivariate logistic regression applied to identify parameters associated with extremely high impairment.

Results

The retrospective study consisted of 2249 children assessed at the first evaluation. Tension type headache (48%), migraine (43%) and functional abdominal pain (11%) were the most common diagnoses with a high rate of co-occurrence; 18% had some form of musculoskeletal pain disease. Irrespective of pain location, chronic pain disorder with somatic and psychological factors was diagnosed frequently (43%). 55% of the children suffered from more than one distinct pain diagnosis. Clinically significant depression and general anxiety scores were expressed by 24% and 19% of the patients, respectively. Girls over the age of 13 were more likely to seek tertiary treatment compared to boys. Nearly half of children suffered from daily or constant pain with a mean pain value of 6/10. Extremely high pain-related impairment, operationalized as a comprehensive measure of pain duration, frequency, intensity, pain-related school absence and disability, was associated with older age, multiple locations of pain, increased depression and prior hospital stays. 43% of the children taking analgesics had no indication for pharmacological treatment.

Conclusion

Children with chronic pain are a diagnostic and therapeutic challenge as they often have two or more different pain diagnoses, are prone to misuse of analgesics and are severely impaired. They are at increased risk for developmental stagnation. Adequate treatment and referral are essential to interrupt progression of the chronic pain process into adulthood.

【 授权许可】

   
2012 Zernikow et al.; licensee BioMed Central Ltd.

【 图 表 】

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