(197) - Change in adolescent and parental emotional behavior determines long-term outcomes for adolescents with chronic pain following interdisciplinary pain management program

Abstract

Chronic pain in adolescents is a serious issue that can lead to decreased social interactions, school absences, and impaired academic performance. In addition to physiologic, psychologic, and social factors, parental anxiety is believed to contribute to the development and maintenance of chronic pain. Retrospectively, we examined the charts of 144 patients, ages 8–18, with various chronic pain conditions and placed them into one of six diagnostic groups: complex regional pain syndrome, abdominal pain, back pain, hypermobility, headache, and fibromyalgia. Data was acquired from patient charts at baseline, post-treatment, and long-term follow-up (one to two months after treatment). We analyzed the course of the adolescent's recovery during an interdisciplinary pain management program and assessed the adolescent's and parent's functioning using the Bath Adolescent Pain Questionnaire and Bath Adolescent Pain-Parental Impact Questionnaire. At baseline, adolescents from all diagnostic groups presented with similar pain intensity and functional scores, and all parents exhibited similar scores on the BAP-PIQ. Following treatment, all adolescents and their parents, regardless of diagnosis, showed significant improvements in pain and emotional functioning, but improvements in pain and emotional function showed little correlation with each other. Future physical and emotional outcomes were predicted by changes in parental self-blame and adolescent emotion during treatment with 84% success rate. We believe chronic pain treatment in adolescents should target these specific components. Effectively treating the child's depression or anxiety and involving parents in therapy to decrease their level of self-blame and can improve long-term outcomes for the patient.