title: Stability of pain parameters and pain-related quality of life in adolescents with persistent pain: a three-year follow-up.
abstract: OBJECTIVE
  Many juveniles with chronic pain of no known organic cause recover. Because adolescents whose pain persists may have chronic pain as adults, a subsample of 42 adolescents from a prevalence study in which continuation of their pain was observed throughout the study period was investigated quantitatively and qualitatively. All mothers (n = 42) completed a questionnaire on the impact of the adolescent's pain on the family. The authors tested the hypothesis that pain parameters, pain-related quality of life, and impact of pain on the family would deteriorate over time.
  
  
  METHODS
  Three-year follow-up questionnaires, diaries, and interviews were used.
  
  
  METHODS
  The study was conducted in the general population in the Rotterdam area.
  
  
  METHODS
  Adolescents (aged 12-18 years) who indicated chronic pain in our previous prevalence study and in a diary and questionnaire each year of the 3-year follow-up were included in the study.
  
  
  RESULTS
  The most prevalent pains were limb pain and headache. The pain intensity was mild (33 mm on a visual analog scale), very frequent (72% of all diary entries), and associated with relatively poor functional status and poor psychological and somatic functioning. The pain parameters, pain-related quality of life, and impact of pain on the family (i.e., restrictions in social life and problems in dealing with the stress of the adolescent's pain) remained surprisingly stable across the assessments. The interviews showed that pain had become part of the daily life of several adolescents, who structured their activities and sleeping hours to prevent aggravation of pain. In particular, adolescents with headache reported problems with cognitive activities, whereas those with limb pain and back pain reported problems with physical activities.
  
  
  CONCLUSIONS
  For adolescents with persistent pain with no known organic cause, intensity and frequency of pain, quality of life, and impact of pain on the family did not change. Generally, they seemed to cope quite well with their pain. In view of these results, further studies should involve follow-up of adolescents with persistent pain into adulthood to establish the determinants of their pain and to find out whether they maintain their adaptive ways of living with their pain.
authors.affiliation: Institute of Medical Psychology and Psychotherapy, Netherland Institute of Health Sciences and Department of General Practice, Erasmus University Rotterdam, The Netherlands. hunfeld@mpp.fgg.eur.nl
authors.forename: Joke A M
authors.initials: JA
authors.lastname: Hunfeld
authors.forename: Christel W
authors.initials: CW
authors.lastname: Perquin
authors.forename: Wieke
authors.initials: W
authors.lastname: Bertina
authors.forename: Alice A J M
authors.initials: AA
authors.lastname: Hazebroek-Kampschreur
authors.forename: Lisette W A
authors.initials: LW
authors.lastname: van Suijlekom-Smit
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.forename: Johannes C
authors.initials: JC
authors.lastname: van der Wouden
authors.forename: Jan
authors.initials: J
authors.lastname: Passchier
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002908:Chronic Disease; D005500:Follow-Up Studies; D006801:Humans; D008499:Medical Records; D009679:Nuclear Family / Q000523:psychology*; D010146:Pain / Q000503:physiopathology* / Q000523:psychology*; D010147:Pain Measurement; D011788:Quality of Life / Q000523:psychology*