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Cognitive behavioral therapy for the treatment of juvenile fibromyalgia: a multisite, single-blind, randomized, controlled clinical trial.
Arthritis Rheum. 2012 Jan; 64(1):297-305.AR

Abstract

OBJECTIVE

Juvenile fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain disorder in children and adolescents for which there are no evidence-based treatments. The objective of this multisite, single-blind, randomized clinical trial was to test whether cognitive-behavioral therapy (CBT) was superior to fibromyalgia (FM) education in reducing functional disability, pain, and symptoms of depression in juvenile FMS.

METHODS

Participants were 114 adolescents (ages 11-18 years) with juvenile FMS. After receiving stable medications for 8 weeks, patients were randomized to either CBT or FM education and received 8 weekly individual sessions with a therapist and 2 booster sessions. Assessments were conducted at baseline, immediately following the 8-week treatment phase, and at 6-month followup.

RESULTS

The majority of patients (87.7%) completed the trial per protocol. Intent-to-treat analyses showed that patients in both groups had significant reductions in functional disability, pain, and symptoms of depression at the end of the study, and CBT was significantly superior to FM education in reducing the primary outcome of functional disability (mean baseline to end-of-treatment difference between groups 5.39 [95% confidence interval 1.57, 9.22]). Reduction in symptoms of depression was clinically significant for both groups, with mean scores in the range of normal/nondepressed by the end of the study. Reduction in pain was not clinically significant for either group (<30% decrease in pain). There were no study-related adverse events.

CONCLUSION

In this controlled trial, CBT was found to be a safe and effective treatment for reducing functional disability and symptoms of depression in adolescents with juvenile FMS.

Authors+Show Affiliations

Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio 45229, USA. Susmita.Kashikar-Zuck@cchmc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22108765

Citation

Kashikar-Zuck, Susmita, et al. "Cognitive Behavioral Therapy for the Treatment of Juvenile Fibromyalgia: a Multisite, Single-blind, Randomized, Controlled Clinical Trial." Arthritis and Rheumatism, vol. 64, no. 1, 2012, pp. 297-305.
Kashikar-Zuck S, Ting TV, Arnold LM, et al. Cognitive behavioral therapy for the treatment of juvenile fibromyalgia: a multisite, single-blind, randomized, controlled clinical trial. Arthritis Rheum. 2012;64(1):297-305.
Kashikar-Zuck, S., Ting, T. V., Arnold, L. M., Bean, J., Powers, S. W., Graham, T. B., Passo, M. H., Schikler, K. N., Hashkes, P. J., Spalding, S., Lynch-Jordan, A. M., Banez, G., Richards, M. M., & Lovell, D. J. (2012). Cognitive behavioral therapy for the treatment of juvenile fibromyalgia: a multisite, single-blind, randomized, controlled clinical trial. Arthritis and Rheumatism, 64(1), 297-305. https://doi.org/10.1002/art.30644
Kashikar-Zuck S, et al. Cognitive Behavioral Therapy for the Treatment of Juvenile Fibromyalgia: a Multisite, Single-blind, Randomized, Controlled Clinical Trial. Arthritis Rheum. 2012;64(1):297-305. PubMed PMID: 22108765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognitive behavioral therapy for the treatment of juvenile fibromyalgia: a multisite, single-blind, randomized, controlled clinical trial. AU - Kashikar-Zuck,Susmita, AU - Ting,Tracy V, AU - Arnold,Lesley M, AU - Bean,Judy, AU - Powers,Scott W, AU - Graham,T Brent, AU - Passo,Murray H, AU - Schikler,Kenneth N, AU - Hashkes,Philip J, AU - Spalding,Steven, AU - Lynch-Jordan,Anne M, AU - Banez,Gerard, AU - Richards,Margaret M, AU - Lovell,Daniel J, PY - 2011/11/24/entrez PY - 2011/11/24/pubmed PY - 2012/2/22/medline SP - 297 EP - 305 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 64 IS - 1 N2 - OBJECTIVE: Juvenile fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain disorder in children and adolescents for which there are no evidence-based treatments. The objective of this multisite, single-blind, randomized clinical trial was to test whether cognitive-behavioral therapy (CBT) was superior to fibromyalgia (FM) education in reducing functional disability, pain, and symptoms of depression in juvenile FMS. METHODS: Participants were 114 adolescents (ages 11-18 years) with juvenile FMS. After receiving stable medications for 8 weeks, patients were randomized to either CBT or FM education and received 8 weekly individual sessions with a therapist and 2 booster sessions. Assessments were conducted at baseline, immediately following the 8-week treatment phase, and at 6-month followup. RESULTS: The majority of patients (87.7%) completed the trial per protocol. Intent-to-treat analyses showed that patients in both groups had significant reductions in functional disability, pain, and symptoms of depression at the end of the study, and CBT was significantly superior to FM education in reducing the primary outcome of functional disability (mean baseline to end-of-treatment difference between groups 5.39 [95% confidence interval 1.57, 9.22]). Reduction in symptoms of depression was clinically significant for both groups, with mean scores in the range of normal/nondepressed by the end of the study. Reduction in pain was not clinically significant for either group (<30% decrease in pain). There were no study-related adverse events. CONCLUSION: In this controlled trial, CBT was found to be a safe and effective treatment for reducing functional disability and symptoms of depression in adolescents with juvenile FMS. SN - 1529-0131 UR - https://www.unboundmedicine.com/medline/citation/22108765/Cognitive_behavioral_therapy_for_the_treatment_of_juvenile_fibromyalgia:_a_multisite_single_blind_randomized_controlled_clinical_trial_ L2 - https://doi.org/10.1002/art.30644 DB - PRIME DP - Unbound Medicine ER -