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Introduction: pain is defined as «an unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage». It suggested that chronic pain in Latin America has regional differences. Characteristics of chronic pain in Mexican adults have been poorly documented. Material and methods: we use a researcher-administered in-person questionnaire that was applied to Mexican adults at urban areas from six major cities of six Mexican States (6 of 32, 19%). Results: researchers interviewed 1,755 subjects. 1,505 questionnaires contained complete data. 286 persons reported pain in one or more anatomical sites that persisted for over three months (19% of the responders). Conclusion: this is the first survey on chronic pain in Mexican adults from urban areas. We need a robust sample to estimate the impact of chronic pain in Mexico. [ABSTRACT FROM AUTHOR]

Objective: The current study focuses on social risk and resilience in an adolescent population with chronic pain. Prior research identifies parental cognitions and behaviors as influential in youths' experiences of chronic pain and pain-related disability. Adolescent development is characterized by greater autonomy from parents and an increased emphasis on peer relationships. Study aims explore the potential protective effect of high-quality adolescent peer relationships on associations between parent and adolescent cognitive and behavioral responses to pain.Method: 238 adolescents with mixed-etiology chronic pain and their parents completed Pediatric Collaborative Health Outcomes Information Registry (Peds-CHOIR) electronic questionnaires prior to their initial visit to a tertiary pediatric pain clinic. Variables in this study include parent catastrophizing, parent protective behavior, adolescent peer relationship quality, adolescent catastrophizing, adolescent functional impairment, and demographic and pain characteristics.Results: As expected, associations between parent and adolescent cognitive and behavioral pain responses were moderated by peer relationship quality. Contrary to expectations, for adolescents endorsing low-quality peer relationships, maladaptive adolescent outcomes were elevated across levels of parental cognitions and behaviors. For adolescents endorsing high-quality peer relationships, adolescent and parent pain responses were linearly related.Conclusions: This study highlights the salience of both family and peer processes in functional outcomes among adolescents with chronic pain. Results suggest that adolescents' adaptive responses to chronic pain may be best supported by the simultaneous presence of adaptive parenting and high-quality peer relationships. Understanding the larger social context in which an adolescent exists is informative in specifying models that predict adaptive outcomes or magnify risks. [ABSTRACT FROM AUTHOR]

Objective: Parental responses influence children's pain; however, the specific role of parental bonding in pediatric pain has not been examined. Depressive symptomology is frequently reported in children with chronic pain (CP) and may play a role in the relationship between parental bonding and pain. This study examined the connections between maternal/paternal bonding (perceived care and control) and symptoms of pain and depression in adolescents with CP and in healthy adolescents.Method: Participants included 116 adolescents (aged 12-17) with CP (n = 55) and without (n = 61). Adolescents completed the Parental Bonding Instrument separately for their mother and father, as well as measures of depression and pain.Results: Significant associations between parental bonding and adolescent pain and depression emerged in the pain group, but not in the healthy group. There were no differences in the impact of maternal versus paternal bonding on adolescent pain and depression. Mediation analyses revealed adolescent depression was a mediator of the relationship between maternal care and adolescent pain, and paternal control and adolescent pain in the group with CP.Conclusions: This study highlights the importance of considering parental bonding and adolescent depression in pediatric CP, suggesting that high paternal control and low maternal care contribute to increased pain in adolescents through heightened adolescent depressive symptoms. The findings emphasize the need for family-based treatment for CP that addresses parent behaviors and adolescent mental health. [ABSTRACT FROM AUTHOR]

Objective: To evaluate patterns of relationships between pain characteristics, peer difficulties, and emotional functioning in a sample of adolescents seeking treatment for chronic pain.Methods: Participants were 172 adolescents (age M = 14.88 years; 76% female, 88% White) with heterogeneous chronic pain disorders who completed measures of pain characteristics, peer difficulties, and emotional functioning before their new patient appointment in a pain management clinic. Direct and indirect relationships between variables were tested using path analysis.Results: Adequate model fit was found for models that specified emotional functioning (anxiety and depression) as a mediator of the relationship between pain interference and peer difficulties. Conversely, poor fit was found for all models specifying peer difficulties as a mediator of the relationship between pain characteristics and emotional functioning.Conclusions: Assessing and targeting depression and anxiety among youth with high pain interference may help prevent or improve peer difficulties. [ABSTRACT FROM AUTHOR]

Sex differences in chronic pain are reported to emerge during adolescence, although it is unclear if this includes responses to treatment. We conducted a meta-analysis to examine whether sex differences were present on outcome variables at pre-treatment, and whether the efficacy of psychological therapies for pediatric chronic pain differs between boys and girls at post-treatment and follow-up time points. Searches were conducted, extending two existing Cochrane reviews of randomized-controlled trials examining the efficacy of psychological therapies for chronic and recurrent pain in children and adolescents. Forty-six articles were eligible for inclusion, and data were extracted regarding pain, disability, anxiety, and depression in boys and girls at pre-treatment, post-treatment, and follow-up time points. No published study reported outcome data separately by sex, so authors of all studies were contacted and 17 studies provided data. Twice as many girls (n =1760) were enrolled into clinical trials of psychological therapies for pediatric chronic pain than boys (n = 828). Girls reported higher depression and anxiety at pre-treatment than boys. Girls with headache also reported significantly greater pre-treatment pain severity. Treatment gains were consistent across the sexes. One exception was for post-treatment disability in children with non-headache pain conditions; girls exhibited a significant effect of treatment relative to control condition (SMD= -0.50[-0.80,-0.20], p < .01), but no such effect was observed for boys (SMD= -0.08[-0.44,0.28], p = .66). Future research should examine whether mechanisms of treatment efficacy differ between boys and girls, and consider the impact of pre-treatment sex differences on response to treatment. [ABSTRACT FROM AUTHOR]

Adolescents with chronic pain are often socially isolated, having never met others with chronic pain, and often feel misunderstood by healthy peers. Adolescence is a sensitive period for developing one's sense of self and autonomy, which often occurs in the context of peer relationships. This developmental process is disrupted in adolescents when their chronic pain interferes with their social interactions. Peer mentoring is proposed as a developmentally timely intervention. The aim of this study is to develop and test the feasibility, acceptability, and impact of the iPeer2Peer program. The iPeer2Peer program is a tailored peer mentorship program that provides modeling and reinforcement by peers (trained young adults with chronic pain aged 18-25 years who have learned to successfully manage their pain). This program aimed to enhance self-management of chronic pain in adolescents through 10 Skype video calls over the course of 8 weeks. A pilot randomized controlled trial design using waitlist controls was used in an adolescent chronic pain sample. Twenty-eight adolescents aged 14.8 ± 1.6 years (93% female) completed the trial (intervention: n = 12; control n = 16). Three adolescents completed the intervention after completing their participation in the control arm. The iPeer2Peer program was feasible and acceptable, provided the adolescents were given more time to complete all 10 calls. When compared with controls, adolescents who completed the iPeer2Peer program had significant improvement in self-management skills and their coping efforts were more successful. The iPeer2Peer program is a promising peer mentoring intervention that complements standard care for adolescents with chronic pain. [ABSTRACT FROM AUTHOR]

Sleep and pain are thought to be bidirectional related on a daily basis in adolescents with chronic pain complaints. In addition, sleep problems have been shown to predict the long-term onset of musculoskeletal pain in middle-aged adults. Yet, the long-term effects of sleep problems on pain duration and different types of pain severity in emerging adults (age: 18-25) are unknown. This study investigated the cross-sectional and longitudinal relationship between sleep problems and chronic pain, and musculoskeletal pain, headache, and abdominal pain severity in a general population of emerging adults. We studied whether these relationships were moderated by sex and whether symptoms of anxiety and depression, fatigue, or physical inactivity mediated these effects. Data of participants from the longitudinal Dutch TRacking Adolescents' Individual Lives Survey were used. Follow-up data were collected in 1753 participants who participated in the fourth (N = 1668, mean age: 19.0 years [SD = 0.6]) and/or fifth (N = 1501, mean age: 22.3 years [SD = 0.6]) assessment wave. Autoregressive cross-lagged models were used for analyses. Sleep problems were associated with chronic pain, musculoskeletal pain, headache and abdominal pain severity, and predicted chronic pain and an increase in musculoskeletal pain severity at 3 years of follow-up. This prospective effect was stronger in females than in males and was mediated by fatigue but not by symptoms of anxiety and depression or physical inactivity. Only abdominal pain had a small long-term effect on sleep problems. Our results suggest that sleep problems may be an additional target for treatment in female emerging adults with musculoskeletal pain complaints. [ABSTRACT FROM AUTHOR]

Background: Chronic pain is common in children and adolescents and is often associated with severe functional disability and mood disorders. The pharmacological treatment of chronic pain in children and adolescents can be challenging, ineffective, and is mostly based on expert opinions and consensus. Ketamine, an N-methyl-D-aspartate receptor antagonist, has been used as an adjuvant for treatment of adult chronic pain and has been shown, in some instances, to improve pain and decrease opioid-requirement. We examined the effects of subanesthetic ketamine infusions on pain intensity and opioid use in children and adolescents with chronic pain syndromes treated in an outpatient setting.Methods: Longitudinal cohort study of consecutive pediatric patients treated with subanesthetic ketamine infusions in a tertiary outpatient center. Outcome measurements included self-reported pain scores (numeric rating scale) and morphine-equivalent intake.Results: Over a 15-month period, 63 children and adolescents (median age 15, interquartile range 12-17 years) with chronic pain received 277 ketamine infusions. Intravenous administration of subanesthetic doses of ketamine to children and adolescents on an outpatient basis was safe and not associated with psychotropic effects or hemodynamic perturbations. Overall, ketamine significantly reduced pain intensity (p < 0.001) and yielded greater pain reduction in patients with complex regional pain syndrome (CRPS) than in patients with other chronic pain syndromes (p = 0.029). Ketamine-associated reductions in pain scores were the largest in postural orthostatic tachycardia syndrome (POTS) and trauma patients and the smallest in patients with chronic headache (p = 0.007). In 37% of infusions, patients had a greater than 20 % reduction in pain score. Conversely, ketamine infusions did not change overall morphine-equivalent intake (p = 0.3).Conclusions: These data suggest that subanesthetic ketamine infusion is feasible in an outpatient setting and may benefit children and adolescents with chronic pain. Further, patients with CRPS, POTS, and a history of trauma-related chronic pain are more likely to benefit from this therapeutic modality. [ABSTRACT FROM AUTHOR]

Little data exist, especially for adolescent and young adult (AYA) persons with haemophilia (PWH), about the relationship between adherence to prescribed treatment regimen and chronic pain. We examined this relationship among PWH (moderate or severe) aged 13-25 via cross-sectional survey. Adherence was assessed using the Validated Hemophilia Regimen Treatment Adherence Scale (VERITAS)-Pro and VERITAS-PRN for prophylactic and on-demand participants respectively. VERITAS scores range from 24 (most adherent) to 120 (least adherent). Chronic pain was measured using the FPS-R and was dichotomized as high for FPS-R scores =4 and low for <4. Logistic regression models were constructed to assess factors associated with having high (vs. low) chronic pain. Of 80 AYA respondents (79 men), most had severe disease (91%), infused prophylactically (86%) and had haemophilia A (91%). Fifty-one per cent were aged 13-17 and most were white (76%), non-Hispanic (88%) and never married (93%). Chronic pain was reported as high for 35% of respondents. Mean VERITAS-Pro scores for those with high and low chronic pain were 53.6 ± 12.3 vs. 47.4 ± 12.9, P = 0.05. VERITAS-PRN scores were similar across chronic pain status. Logistic regression revealed that for each 10-point reduction (i.e. increase in adherence) in the combined VERITAS (Pro and PRN) and VERITAS-Pro scores there was a 35% (OR = 0.65; 95%CI = 0.44, 0.96; P = 0.03) and 39% (OR = 0.61; 95%CI = 0.39, 0.96; P = 0.03) reduction in odds of having high chronic pain respectively. Among AYA PWHs, better adherence was associated with significantly lower odds of having high chronic pain. Moreover, non-whites were >4 times as likely as whites to report high chronic pain. [ABSTRACT FROM AUTHOR]

Objective To examine associations between parental history of pain and catastrophizing and their adolescent’s pain, somatic symptoms, catastrophizing, and disability. Methods Participants included 178 youths aged 11–14 years recruited through public schools. Adolescents completed measures assessing pain characteristics, somatic symptoms, and pain catastrophizing. Parents reported on their own pain, and catastrophizing about their adolescent’s pain. Results About one quarter of the adolescents and two thirds of parents reported having pain. Parent pain was associated with adolescent pain, somatic symptoms, and pain catastrophizing. Parent catastrophizing was a significant predictor of adolescent somatic symptoms and pain-related disability, beyond the contribution of parent pain. Adolescent catastrophizing mediated the association between parent catastrophizing and adolescent pain-related disability. Conclusions Parent history of pain and pain-related cognitions may contribute to adolescent risk for chronic pain. [ABSTRACT FROM AUTHOR]

Objective To examine “miscarried helping” as a maladaptive dyadic process in families of youth with chronic pain using the Actor–Partner Interdependence Model. Methods 210 adolescents with chronic pain (mean = 14.23 years; 73.9% female) and their parents participating in a multicenter study completed measures assessing pain characteristics, miscarried helping, family functioning, parental protectiveness, and child depressive symptoms. Results Multilevel modeling revealed significant actor effects of miscarried helping on family functioning for both parents and teens, but not partner effects. Individual-level factors, including child pain characteristics, depressive symptoms, and parental protectiveness, uniquely contributed to miscarried helping. Conclusions Higher perceptions of miscarried helping contribute to worse family functioning and may be a useful target for psychological intervention in parents of children with chronic pain. Parents who exhibit more protective responses to pain and youth with more depressive symptoms may be at increased risk for a miscarried helping process to develop. [ABSTRACT FROM AUTHOR]

Objectives: This study was designed to investigate whether an individual and parental history of functional pain syndromes (FPS) is found more often in adolescents suffering from chronic pain than in their pain-free peers. Methods: Our case-control study involved 101 adolescents aged 10-18 years. Cases were 45 patients of the Chronic Pain Clinic at Sydney Children's Hospital with diverse chronic pain disorders. Controls consisted of 56 adolescent volunteers who did not have chronic pain. Adolescents and their parents filled out questionnaires assessing demographic data as well as known and potential risk factors for chronic pain. A history of FPS was assessed by questionnaire, including restless legs syndrome (RLS). Chi-squared tests and t-tests were used to investigate univariate associations between chronic pain in adolescents and lifetime prevalence of FPS. Logistic regression was used to test multivariate associations, while controlling for possible confounders. Results: Migraine, non-migraine headaches, recurrent abdominal pain (RAP), and RLS were reported significantly more frequently in cases than controls (P-values of 0.01, ,0.001, 0.01, and 0.03, respectively). Parental migraine, RAP, and RLS were also significantly associated with adolescent chronic pain in the multivariate analyses. Individual history of migraine, non-migraine headaches, and RAP, along with parental history of RAP and depression significantly accounted for 36%-49% of variance in chronic pain. Other associations with chronic pain were generally in accordance with previous reports. Discussion: It may be helpful when assessing a child who has chronic pain or is at risk of chronic pain, to enquire about these associations. Based on the current findings, an individual history of migraine, non-migraine headaches, and RAP, as well as parental migraine, RAP, and RLS are symptoms that are of particular relevance to assess. [ABSTRACT FROM AUTHOR]

Abstract: The importance of willingness to adopt a self-management approach to chronic pain has been demonstrated in the context of cognitive-behaviorally oriented interdisciplinary pain treatment programs for adults, both as a treatment outcome and as a process that facilitates functional improvements. Willingness to self-manage pain has not been studied in pediatric interdisciplinary pain treatment settings. Study aims were (1) to investigate willingness to self-manage pain among children and parents undergoing intensive interdisciplinary pain treatment and (2) to determine whether increased willingness to self-manage pain influenced functional treatment outcomes. A total of 157 children ages 10 to 18 and their parents enrolled in a pediatric pain rehabilitation program completed the Pain Stages of Change Questionnaire (PSOCQ youth and parent versions) at pretreatment, posttreatment, and short-term follow-up. They also reported on pain, functional disability, depressive symptoms, fear of pain, and use of passive and accommodative coping strategies. Results show that willingness to self-manage pain increased during treatment among both children and parents, with gains maintained at follow-up. Increases in children’s readiness to self-manage pain from pretreatment to posttreatment were associated with decreases in functional disability, depressive symptoms, fear of pain, and use of adaptive coping strategies. Increases in parents’ readiness to adopt a pain self-management approach were associated with changes in parent-reported fear of pain but not with other child outcomes. Few associations emerged between pretreatment willingness to self-manage pain and posttreatment outcomes. Findings suggest that interdisciplinary pediatric pain rehabilitation may facilitate increased willingness to self-manage pain, which is associated with improvements in function and psychological well-being. [Copyright &y& Elsevier]

The article discusses major psychosocial factors that affect pediatric pain and disability. It explores the chronic pain both in adolescents and children, which is linked with developmental experiences' major disruption crucial to quality of life, personal adjustment, and social and vocational success. It proposes an explanatory model for pain and functional disability's development and maintenance concepualization. It reviews systemic treatment and cognitive behavioral approaches based on representative evidence for functioning improvement in such pediatric population.

Abstract: The aim of this study was to determine the prevalence of self-reported chronic idiopathic pain among adolescents in relation to age and gender, and to explore how pain interferes with daily activities. The study was performed in Nord-Trøndelag County, Norway in 2006–2008. All adolescents were invited to participate; the response rate was 78%. Participants completed a comprehensive questionnaire, including questions about pain and interference with everyday life. Chronic idiopathic pain was defined as pain at least once a week during the last 3months, not related to any known disease or injury. The final study population, with complete pain questionnaires, consisted of 7373 adolescents aged 13–18years. Chronic pain was reported by 44.4% of the participants, and 25.5% reported pain in at least 2 locations. Chronic idiopathic musculoskeletal pain was most prevalent (33.4%), and the neck/shoulder was most commonly affected. Musculoskeletal pain in 3 or more locations was reported by 8.5%. Pain almost daily was reported by 10.2%. More girls than boys reported pain. In girls, the prevalence of pain increased with age. A high number of pain-associated disabilities were reported, and 58.5% described difficulties doing daily activities in leisure time. Subjective disabilities were higher in girls, and increased with the frequency of pain and the number of pain locations, as shown by high disability in adolescents with musculoskeletal pain in 3 or more locations. Chronic idiopathic pain, especially multisite pain, is common among adolescents, and those suffering from it report a major impact on several areas of daily living. [Copyright &y& Elsevier]

Abstracts from the Australian Pain Society Conference, held June 12-16, 2011 in Darwin, Northern Territory, are presented including "Demographics and pain characteristics of patients attending a paediatric pain clinic in Melbourne, Australia," "Yuck: the influence of disgust on the venipuncture experience in adolescents and adults," and "Associations between chronic pain disorders in adolescents and history of functional pain syndromes: a case-control study."

Objective: The aim of the study was to ascertain the prevalence of multiple pains (MPs) and detect psychosocial risk factors assessed 1 year previously. Method: MPs were defined by the number of sites where pain was reported to occur at least “sometimes” in a general population sample of 2,219 German youths. Results: Two or more sites of recurrent pain were reported by 54% of the participants, whereas 27% reported no pains. Girls were much more prone to MPs than boys. Stability of MP was high in the two waves. Regression analysis revealed that prior MP, age, sex, internalizing/externalizing symptoms, and time spent with visual media explained 25% of the variance: the contribution of the psychosocial factors to the model was small. Separate analyses for boys and girls displayed different risk-factor profiles and a higher degree of predictability in girls. Conclusion: A supposedly biological disposition, namely pain vulnerability, being particularly high in girls, is assumed to build the basis of pains felt in various sites of the body. Further research is needed to corroborate and specify these assumptions. [ABSTRACT FROM PUBLISHER]

Abstract: The purpose of this meta-analytic review was to quantify the effects of psychological therapies for the management of chronic pain in youth. Specifically, in this review we updated previous systematic reviews of randomized controlled trials by including new trials, and by adding disability and emotional functioning to pain as treatment outcomes. Electronic searches of the Cochrane Register of Randomised Controlled Trials, MEDLINE, PsycLIT, EMBASE, and the Social Sciences Citation Index were conducted from inception through August 2008. Methodological quality of the studies was assessed, and data extracted on the three primary outcomes of interest. Twenty-five trials including 1247 young people met inclusion criteria and were included in the meta-analysis. Meta-analytic findings demonstrated a large positive effect of psychological intervention on pain reduction at immediate post-treatment and follow-up in youth with headache, abdominal pain, and fibromyalgia. Small and non-significant effects were found for improvements in disability and emotional functioning, although there were limited data on these outcomes available in the included studies. Omnibus cognitive–behavioral therapy, relaxation therapy, and biofeedback all produced significant and positive effects on pain reduction. Studies directly comparing the effects of self-administered versus therapist-administered interventions found similar effects on pain reduction. Psychological therapies result in improvement in pain relief across several different pain conditions in children. Future trials are needed that incorporate non-pain outcome domains, that focus significant therapeutic content on reductions in disability, and that include extended follow-up to better understand maintenance of treatment effects. [Copyright &y& Elsevier]

Abstract: Emerging evidence has indicated that adolescent chronic pain is a significant healthcare issue, the impact of which is determined by a complex interplay of biological, emotional, social, and familial factors. Recently, progress has been made in assessment of pain and functioning in adolescents with chronic pain. A next step is to evaluate whether discrete subgroups of patients exist and whether assessment measures can be used to determine subgroup membership for individual pain sufferers. The present study sought to address these two issues. A battery of questionnaires, including the bath adolescent pain questionnaire, was completed by 209 adolescents with chronic pain presenting for an assessment appointment. Results from cluster analyses indicated the presence of four distinct subgroups. Three clusters differed from one another along a single continuum of severity and the fourth was characterized by good family cohesion, moderate emotional difficulties, and significant difficulties with physical functioning. Follow-up analyses indicated significant differences among the clusters across eight of nine measures of functioning including pain intensity, healthcare utilization, school attendance, amount of weekly exercise, depression, disability, social functioning, and catastrophic thinking. A discriminant analysis was able to correctly classify over 95% of participants into the correct cluster. These results provide strong support for the derived four cluster solution, which may be useful in both clinical and research settings, as it allows for individual adolescent pain sufferers to be classified into groupings according to the severity and type of difficulties being experienced. [Copyright &y& Elsevier]

Aim: To explore the usefulness of the Pain-O-Meter sensory and affective words scale (POM-WDS) with regard to whether children aged 6–16 who suffer from chronic and acute pain know the words and what words they chose to describe their pain. Methods: Sixty-one children participated, mean age 11 y, suffering from acute pain (n=25) and pain associated with juvenile idiopathic arthritis (JIA, n=36). Children rated their pain intensity on the POM-VAS (visual analogue scale, 0–10 cm). Thereafter, children were asked whether each sensory and affective word on the POM-WDS was known to them, and whether each word described their pain experience. Results: Seventeen out of 23 words were known to at least 70% of the sample. The least recognized word was grinding. Children age 6–16 knew fewer words than the adolescents. Age was a significant determinant for whether the children knew the words grinding (odds ratio (OR) 20.08, p<0.01), gnawing (OR 5.92, p < 0.05), unbearable (OR 8.02, p<0.05), and excruciating (OR 20.17, p<0.001). Terrible (OR 33.3, p<0.05), aching (OR 44.5, p<0.05) and sore (OR 5.4, p<0.05) were selected more often by children with acute pain than with JIA.Conclusion: Further studies will be required to determine the suitability of using the POM-WDS with children. [ABSTRACT FROM AUTHOR]

Chronic pain is a common secondary problem associated with cerebral palsy (CP). This pain may be due to the musculoskeletal problems that often accompany CP, including spasticity, scoliosis, and bony deformity. The purpose of this study was to determine the effects of biofeedback-assisted relaxation training on self-reported pain and muscle tension in 3 adults with CP using a multiple baseline design across subjects. Two of 3 participants reported decreases in their pain experiences posttreatment. Their subjective reports, however, did not correspond with physiological changes. Complications in the use of progressive relaxation exercises and EMG biofeedback equipment are described and suggestions for future research provided. [ABSTRACT FROM AUTHOR]

Chronic pain is complex and there is still much to discover about the burden that it places on children and their families. The aim of this study was to explore the way in which the experience of chronic pain impacts on the lives of young people. Through the use of a pain workshop that involved a series of guided activities and a focus group, young people were able to share their experiences with each other and the facilitators/researchers. Data were analysed using a theoretical coding technique supported by Atlas.ti. Five key interlinked themes emerged from the data and each theme is expressed in the words of the young people themselves: 'no one's pain's the same', 'getting on with it', 'it's hard 'cos...', 'keeping with the dream', and 'it depends ... some are OK'. The young people did experience significant disruption in their lives as a result of their pain. Pain was experienced as if it was both a separate entity as well as an intrinsic part of them and, to a degree, blighted their future. Based on the experiences shared by the young people, professionals need to develop insight and strategies into the challenges young people with chronic pain face on a daily basis. [ABSTRACT FROM AUTHOR]

The differences in quality of life and school absence were studied in one hundred adolescents from the open population who had reported chronic headache or chronic, physically unexplained, pain at other locations. The adolescents kept a 3-week diary about their pain and completed a quality of life questionnaire. Of all chronic pain sufferers in this study, it was the adolescents with headache who showed the least frequent pain, but they reported the poorest quality of life and the largest school absence due to their pain. Adolescents with headache or adolescents with back pain showed the highest negative correlations between pain parameters and quality of life. Headache sufferers showed highly negative relationships between pain parameters and most quality of life domains (median r = -0.46), and only in headache sufferers did this involve both intensity and frequency of pain. Qualitative studies are needed to reveal the background to these differences. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To evaluate short and long-term treatment outcome of children (7–10 years) in comparison to adolescents (11–18 years) with disabling chronic pain following multimodal inpatient pain treatment. Patients and methods: Thirty-three children and 167 adolescents underwent multimodal inpatient pain treatment. Standardized assessment of pain-related variables, disability, coping, and use of analgesics was performed at admission, 3- and 12-month follow-up. Results: Children and adolescents displayed similar pain-characteristics at admission. Adolescents demonstrated significantly higher disability and passive pain coping. Children relied more on others when in pain. All core variables (i.e., pain intensity, pain-related disability, school absence and pain-related coping) decreased significantly in both children and adolescents after 3 months. Both groups maintained this decline 12 months later. More than half of the children and adolescents demonstrated a 50%-reduction in pain intensity after 3 months, and almost 60% after 12 months. Use of analgesics was significantly reduced at 3-month follow-up with no additional changes after 12 months. While age did not exert any impact on results, there were significant gender differences in pain intensity and school absence. Girls demonstrated higher pain intensity and higher school absence 1 year following treatment. Conclusions: Children display similar pain-characteristics to adolescents when entering inpatient treatment. A multimodal inpatient program appears to stop the the long-term vicious cycle of disability and pain for both children and adolescents. The demonstrated gender differences raise issues for further research and the possiblity of additional pain management strategies for girls. [Copyright &y& Elsevier]