OBJECTIVES: 1) To determine the importance of psychological
adjustment and family functioning in primary juvenile
fibromyalgia by assessing these factors in children with
fibromyalgia and in their parents, compared with children with
juvenile rheumatoid arthritis (JRA) and with pain-free control
children and their parents. 2) To examine which of these
factors predict functional disability.
METHODS: Fifteen children in each of the 3 study groups, and
their parents, completed self-report questionnaires and pain
diaries. A medical evaluation of each child was performed,
including assessment of tender points by palpation and by
RESULTS: All children in the fibromyalgia group met the Yunus
and Masi criteria for fibromyalgia, and 11 met the American
College of Rheumatology criteria. There were almost no
significant group differences in the children's or parents'
psychological adjustment, ratings of family functioning, or
coping strategies. Significant group differences in functional
disability, pain, fatigue, tender point threshold, and control
point tolerance were found. A number of the psychological
adjustment, pain, fatigue, and coping variables were
significantly associated with functional disability.
CONCLUSION: The notion that fibromyalgia is a psychogenic
condition is not supported by these results. Fibromyalgia is
associated with disability of a magnitude comparable to that
of other chronic pain conditions. Disability among children
with fibromyalgia or JRA is a function of the children's
psychological adjustment and physical state, and of the
parents' physical state and method of coping with pain.