According to a recent multi-site trial published in Arthritis & Rheumatism, a peer-reviewed journal of the American College of Rheumatology (ACR), cognitive-behavioral therapy (CBT) reduces functional disability and depressive symptoms in adolescent with juvenile fibromyalgia. The trial demonstrated that the psychological therapy was safe and effective as well as superior to disease management education.

According to medical evidence approximately 2 to 7% of school-aged children are affected by juvenile fibromyalgia syndrome, which similar as in adults, predominantly affects adolescent girls. The characteristics in both adult and juvenile fibromyalgia patients are widespread musculoskeletal pain, fatigue together with sleep and mood disturbances. Earlier studies have established that juvenile fibromyalgia patients suffer from substantial physical, school, social and emotional impairments. So far, there are only few studies for treating the juvenile form of the disorder.

Study leader Dr. Susmita Kashikar-Zuck from the Division of Behavioral Medicine and Clinical Psychology at Cincinnati Children's Hospital Medical Center in Ohio and her team decided to investigate fibromyalgia in juveniles and enrolled 114 adolescents who were diagnosed with the disorder between the ages of 11 to 18 years. The trial was carried out at four pediatric rheumatology centers from December 2005 to 2009. Participants were randomized to cognitive-behavioral therapy or fibromyalgia education in form of eight weekly individual therapy sessions and two additional sessions in the six months after completion of the active therapy.

At the end of the trial, the findings demonstrated that both patient groups showed a substantial reduction in functional disability, pain, and depressive symptoms. According to the researchers, pediatric participants in the cognitive-behavioral therapy group displayed a substantially lower functional disability with an improvement of 37% in disability compared with those in the fibromyalgia education group who achieved a 12% disability improvement. At study-end both groups had scored in the non-depressed range, however, pain reduction was clinically insignificant with a decrease in pain of less than 30% in both groups.

More than 85% of the participants attended all therapy sessions, meaning that only few participants dropped out, and researchers reported no study-related adverse events.

Dr. Kashikar-Zuck concludes:

"Our trial confirms that cognitive-behavioral therapy is a safe and effective treatment for reducing functional disability and depression in patients with juvenile fibromyalgia. When added to standard medical care, cognitive-behavioral therapy helps to improve daily functioning and overall wellbeing for adolescents with fibromyalgia."

Written by Petra Rattue