Cognitive Behavioral Treatment of Pain in Women and Girls with Juvenile Fibromyalgia
摘要
Juvenile Fibromyalgia (JFM) is a poorly understood chronic pain condition characterized by widespread musculoskeletal pain, fatigue, sleep disruption, and frequently accompanied by other somatic symptoms such as headache, gastrointestinal dysfunction, and dysautonomia (Coles et al., Pediatr Rheumatol 19, 2021; Vincenzo et al., Acta Biomed 90:134, 2019; Weiss and Kashikar-Zuck, Fibromyalgia syndrome, Springer, 2021; Lynch-Jordan et al., Arthritis Care Res 75:1795–1803, 2023). JFM affects young girls at a higher rate than their male counterparts (Coles et al., Pediatr Rheumatol 19, 2021) and can be highly disabling and disruptive to physical, academic, and psychosocial functioning (Kashikar-Zuck et al., Arthritis Care Res 57:474–480, 2007). Given that JFM symptoms overlap with many other conditions and that JFM can be comorbid with other conditions, the diagnostic journey is often long and difficult for teens (Häuser and Fitzcharles, Dialogues Clin Neurosci 20:53–62, 2018; Rahman et al., BMJ 348, 2014). This process may be especially taxing on young women and girls, who are more likely to experience invalidation and dismissal of pain and fatigue in the medical system (Igler et al., J Child Health Care 21:381–391, 2017) as well as stigma from peers and school personnel (Wakefield et al., Pain Reports 3:e679, 2018). This healthcare journey could lead to mistrust in medical professionals and social isolation, making treatment uniquely challenging. Recommended treatment for ongoing pain, fatigue, and impairment in JFM is a combination of cognitive behavioral therapy, complementary health therapies, and physical exercise (Rahman et al., BMJ 348, 2014; Kashikar-Zuck et al., J Pain 19:1049-1062, 2018).