title: School functioning in adolescents with chronic pain: the role of depressive symptoms in school impairment.
abstract: OBJECTIVE
  To explore associations between depressive symptoms and school functioning, including school attendance, academic performance, self-perceived academic competence, and teacher-rated school adjustment among predominantly Caucasian and female adolescent chronic pain patients.
  
  
  METHODS
  A total of 217 clinically referred adolescents (aged 12-17 years) and their parents completed measures of pain characteristics, depression, and school functioning. Additional data were collected from school records and teacher reports.
  
  
  RESULTS
  Depressive symptoms strongly correlated with school functioning indicators. In linear regression analyses, higher levels of depressive symptoms predicted more school impairment. A model testing whether depressive symptoms mediated the association between current pain intensity and parent perceptions of the interference of pain on school functioning was supported by the data.
  
  
  CONCLUSIONS
  Depressive symptoms play a key role in influencing the extent of school impairment in adolescents with chronic pain. Interventions to alleviate depressive symptoms may enhance treatments designed to improve school functioning in this population.
authors.affiliation: Pain Treatment Service, Children's Hospital Boston, Boston, MA 02115, USA. Deirdre.logan@childrens.harvard.edu
authors.forename: Deirdre E
authors.initials: DE
authors.lastname: Logan
authors.forename: Laura E
authors.initials: LE
authors.lastname: Simons
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Kaczynski
mesh_terms: D000041:Absenteeism; D000124:Achievement; D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D004645:Empathy; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D010146:Pain / Q000523:psychology*; D010379:Peer Group; D010552:Personality Assessment; D012044:Regression Analysis; D012917:Social Adjustment; D013334:Students / Q000523:psychology*