Mindfulness-Based Stress Reduction for Adolescents with Functional Somatic Syndromes: A Pilot Cohort Study

被引:44
作者
Ali, Ather [1 ,2 ]
Weiss, Theresa R. [1 ]
Dutton, Anne [3 ]
McKee, Douglas [4 ]
Jones, Kim D. [5 ,6 ]
Kashikar-Zuck, Susmita [7 ]
Silverman, Wendy K. [8 ,9 ]
Shapiro, Eugene D. [1 ,10 ]
机构
[1] Yale Univ, Dept Pediat, New Haven, CT 06520 USA
[2] Yale Univ, Dept Med, New Haven, CT 06520 USA
[3] Yale Univ, Dept Psychiat, New Haven, CT 06520 USA
[4] Yale Univ, Dept Econ, New Haven, CT 06520 USA
[5] Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR 97201 USA
[6] Oregon Hlth & Sci Univ, Sch Med, Portland, OR 97201 USA
[7] Univ Cincinnati, Dept Pediat, Cincinnati, OH USA
[8] Yale Univ, Ctr Child Study, New Haven, CT 06520 USA
[9] Yale Univ, Dept Psychol, New Haven, CT USA
[10] Yale Univ, Dept Epidemiol Microbial Dis, New Haven, CT USA
基金
美国国家卫生研究院;
关键词
COGNITIVE-BEHAVIORAL THERAPY; IRRITABLE-BOWEL-SYNDROME; CHRONIC-FATIGUE-SYNDROME; CHRONIC PAIN; FIBROMYALGIA; MEDITATION; CHILDREN; MECHANISMS; ANXIETY; IMPACT;
D O I
10.1016/j.jpeds.2016.12.053
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To assess the feasibility of a mindfulness-based stress reduction (MBSR) program for adolescents with widespread chronic pain and other functional somatic symptoms and to make preliminary assessments of its clinical utility. Study design Three cohorts of subjects completed an 8-week MBSR program. Child-and parent-completed measures were collected at baseline and 8 and 12 weeks later. Measures included the Functional Disability Inventory (FDI), the Fibromyalgia/Symptom Impact Questionnaire-Revised (FIQR/SIQR), the Pediatric Quality of Life Inventory, the Multidimensional Anxiety Scale (MASC2), and the Perceived Stress Scale. Subjects and parents were interviewed following the program to assess feasibility. Results Fifteen of 18 subjects (83%) completed the 8-week program. No adverse events occurred. Compared with baseline scores, significant changes were found in mean scores on the FDI (33% improvement, P = .026), FIQR/SIQR (26% improvement, P = .03), and MASC2 (child: 12% improvement, P = .02; parent report: 17% improvement, P = .03) at 8 weeks. MASC2 scores (child and parent) and Perceived Stress Scale scores were significantly improved at 12 weeks. More time spent doing home practice was associated with better outcomes in the FDI and FIQR/SIQR (44% and 26% improvement, respectively). Qualitative interviews indicated that subjects and parents reported social support as a benefit of the MBSR class, as well as a positive impact of MBSR on activities of daily living, and on pain and anxiety. Conclusions MBSR is a feasible and acceptable intervention in adolescents with functional somatic syndromes and has preliminary evidence for improving functional disability, symptom impact, and anxiety, with consistency between parent and child measures.
引用
收藏
页码:184 / 190
页数:7
相关论文
共 67 条
[1]   Mechanisms of the placebo response in pain in osteoarthritis [J].
Abhishek, A. ;
Doherty, M. .
OSTEOARTHRITIS AND CARTILAGE, 2013, 21 (09) :1229-1235
[2]   Recurrent pain, stress, tender points and fibromyalgia in childhood: an exploratory descriptive clinical study [J].
Alfven, Gosta .
ACTA PAEDIATRICA, 2012, 101 (03) :283-291
[3]   Complementary and Integrative Methods in Fibromyalgia [J].
Ali, Ather ;
McCarthy, Paul L. .
PEDIATRICS IN REVIEW, 2014, 35 (12) :510-518
[4]   Experiences of patients identifying with chronic Lyme disease in the healthcare system: a qualitative study [J].
Ali, Ather ;
Vitulano, Lawrence ;
Lee, Robert ;
Weiss, Theresa R. ;
Colson, Eve R. .
BMC FAMILY PRACTICE, 2014, 15
[5]  
[Anonymous], 2009, Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness
[6]  
Bennett RM, 2009, ARTHRITIS RES THER, V11, DOI [10.1186/ar2830, 10.1186/ar2783]
[7]   Minimal Clinically Important Difference in the Fibromyalgia Impact Questionnaire [J].
Bennett, Robert M. ;
Bushmakin, Andrew G. ;
Cappelleri, Joseph C. ;
Zlateva, Gergana ;
Sadosky, Alesia B. .
JOURNAL OF RHEUMATOLOGY, 2009, 36 (06) :1304-1311
[8]   Fibromyalgia and Chronic Fatigue Syndrome: Management Issues [J].
Bourke, Julius .
CLINICAL CHALLENGES IN THE BIOPSYCHOSOCIAL INTERFACE: UPDATE ON PSYCHOSOMATICS FOR THE 21ST CENTURY, 2015, 34 :78-91
[9]  
Bujoreanu Simona, 2014, Hosp Pediatr, V4, P283, DOI 10.1542/hpeds.2014-0023
[10]   Brain responses to visceral and somatic stimuli in patients with irritable bowel syndrome with and without fibromyalgia [J].
Chang, L ;
Berman, S ;
Mayer, EA ;
Suyenobu, B ;
Derbyshire, S ;
Naliboff, B ;
Vogt, B ;
FitzGerald, L ;
Mandelkern, MA .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2003, 98 (06) :1354-1361