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Abstract
Aims: To describe and quantify impairment in an outpatient population of children with chronic pain of unknown origin (UCP).
Methods: A total of 149 children who presented with pain of at least three months’ duration and without a satisfactory explanation at presentation were studied. Number of somatic complaints (Children’s Somatisation Inventory, CSI), pain intensity (VAS, 0–10 cm), functional disability (Child Health Questionnaire (CHQ-CF) and clinical history), and general health perceptions (CHQ) were determined.
Results: Mean age of the children was 11.8 years; 73% were girls. Overall, 72% suffered impairment in sports activities, 51% reported absence from school, 40% experienced limitations in social functioning, and 34% had problems with sleeping. Mean number of somatic symptoms differed significantly between boys (8.4) and girls (10.7). The CHQ-CF scores for physical functioning, role/social functioning, and general health perceptions were 76.4, 70.7, and 57.5, respectively, indicating substantial impairment on all domains. The mean pain intensity was 4.7 for current and 7.1 for worst pain. Children solely evaluated by a general practitioner prior to referral reported less, though still substantial, impairment. Low general health perceptions, impaired role/social functioning, high pain intensity, and having headache or musculoskeletal pain were independent predictors of having significant impairment.
Conclusions: Referred children with UCP show substantial impairment on multiple domains in daily life.
- CHQ-CF, Child Health Questionnaire Child Form
- UCP, unexplained chronic pain
- CSI, Children’s Somatisation Inventory
- C group, the group of children referred by a consultant physician or surgeon
- GHP, General Health Perceptions (scale CHQ-CF)
- GP group, the group of children solely evaluated by their general practitioner prior to referral
- PF, Physical Functioning (scale CHQ-CF)
- PPQ, Pediatric Pain Questionnaire
- PUC study, Pain of Unknown origin in Children Study
- RP, Role and Social Functioning (scale CHQ-CF)
- VAS, Visual Analogue Scale
- pain
- chronic disease
- quality of life
- functional disability
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- CHQ-CF, Child Health Questionnaire Child Form
- UCP, unexplained chronic pain
- CSI, Children’s Somatisation Inventory
- C group, the group of children referred by a consultant physician or surgeon
- GHP, General Health Perceptions (scale CHQ-CF)
- GP group, the group of children solely evaluated by their general practitioner prior to referral
- PF, Physical Functioning (scale CHQ-CF)
- PPQ, Pediatric Pain Questionnaire
- PUC study, Pain of Unknown origin in Children Study
- RP, Role and Social Functioning (scale CHQ-CF)
- VAS, Visual Analogue Scale
Footnotes
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Competing interests: none declared