title: Cognitive behavioral therapy for the treatment of juvenile fibromyalgia: a multisite, single-blind, randomized, controlled clinical trial.
abstract: OBJECTIVE
  Juvenile fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain disorder in children and adolescents for which there are no evidence-based treatments. The objective of this multisite, single-blind, randomized clinical trial was to test whether cognitive-behavioral therapy (CBT) was superior to fibromyalgia (FM) education in reducing functional disability, pain, and symptoms of depression in juvenile FMS.
  
  
  METHODS
  Participants were 114 adolescents (ages 11-18 years) with juvenile FMS. After receiving stable medications for 8 weeks, patients were randomized to either CBT or FM education and received 8 weekly individual sessions with a therapist and 2 booster sessions. Assessments were conducted at baseline, immediately following the 8-week treatment phase, and at 6-month followup.
  
  
  RESULTS
  The majority of patients (87.7%) completed the trial per protocol. Intent-to-treat analyses showed that patients in both groups had significant reductions in functional disability, pain, and symptoms of depression at the end of the study, and CBT was significantly superior to FM education in reducing the primary outcome of functional disability (mean baseline to end-of-treatment difference between groups 5.39 [95% confidence interval 1.57, 9.22]). Reduction in symptoms of depression was clinically significant for both groups, with mean scores in the range of normal/nondepressed by the end of the study. Reduction in pain was not clinically significant for either group (<30% decrease in pain). There were no study-related adverse events.
  
  
  CONCLUSIONS
  In this controlled trial, CBT was found to be a safe and effective treatment for reducing functional disability and symptoms of depression in adolescents with juvenile FMS.
authors: Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio 45229, USA. Susmita.Kashikar-Zuck@cchmc.org
authors: Susmita
authors: S
authors: Kashikar-Zuck
authors: Tracy V
authors: TV
authors: Ting
authors: Lesley M
authors: LM
authors: Arnold
authors: Judy
authors: J
authors: Bean
authors: Scott W
authors: SW
authors: Powers
authors: T Brent
authors: TB
authors: Graham
authors: Murray H
authors: MH
authors: Passo
authors: Kenneth N
authors: KN
authors: Schikler
authors: Philip J
authors: PJ
authors: Hashkes
authors: Steven
authors: S
authors: Spalding
authors: Anne M
authors: AM
authors: Lynch-Jordan
authors: Gerard
authors: G
authors: Banez
authors: Margaret M
authors: MM
authors: Richards
authors: Daniel J
authors: DJ
authors: Lovell
mesh_terms: D000293:Adolescent; D002648:Child; D059350:Chronic Pain / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004185:Disability Evaluation; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006304:Health Status; D006801:Humans; D008297:Male; D010147:Pain Measurement; D017288:Pain Threshold; D010173:Palpation; D011788:Quality of Life; D016896:Treatment Outcome