Sabrina Gmuca1,2,3,4,5, Maitry Sonagra6,7,8, Rui Xiao7,9, Kimberly S Miller6,10, Nina H Thomas10,11,12, Jami F Young8,10,12, Pamela F Weiss6,7,10, David D Sherry6,10, Jeffrey S Gerber7,10,13. 1. Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, USA. gmucas@chop.edu. 2. Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA. gmucas@chop.edu. 3. PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA. gmucas@chop.edu. 4. University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, Philadelphia, USA. gmucas@chop.edu. 5. Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, 11214, Philadelphia, PA, 19146, USA. gmucas@chop.edu. 6. Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, USA. 7. Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA. 8. PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA. 9. Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, USA. 10. University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, Philadelphia, USA. 11. Center for Phenomic Science, Children's Hospital of Philadelphia, Philadelphia, USA. 12. Department of Child and Adolescent Psychiatry and Behavioral Services, Children's Hospital of Philadelphia, Philadelphia, USA. 13. Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, USA.
Abstract
BACKGROUND: To characterize suicidality among youth with juvenile fibromyalgia syndrome (JFMS) receiving treatment from pediatric rheumatologists at a tertiary care center in order to determine the prevalence of suicidality in JFMS and to explore risk factors for persistent suicidal ideation. METHODS: We performed a cross-sectional cohort study of children 12-17 years old with JFMS seen in a specialty pediatric rheumatology pain clinic from 7/2017-9/2019. All subjects completed patient-reported outcomes measures, complemented by retrospective chart review. Subjects who endorsed item 8 on the Children's Depression Inventory, 2nd Edition (CDI-2) were categorized as endorsing suicidal ideation. We assessed for differences between the suicidal and non-suicidal patients using Wilcoxon-rank sum test. Logistic regression modeling was performed to identify psychosocial factors associated with suicidality. RESULTS: Of the 31 subjects, more than one-quarter endorsed suicidality. Nearly 90% of teens with suicidal ideation were established in outpatient counseling. In bivariate analyses, suicidality was associated with lower resilience and greater depression and anxiety (all p < 0.05). Pain intensity trended towards a statistically significant positive association (OR: 1.16 [0.99-1.37]; p = 0.06). Lower resilience was independently associated with suicidality (OR: 0.90 [95% CI: 0.82-0.98]; p < 0.02). CONCLUSIONS: Suicidality was prevalent among youth with JFMS and persistent despite concurrent receipt of mental health services. Higher patient-level resilience was independently associated with a reduced odds of suicidality. Future work should examine the role of resilience training on reducing psychological distress and mitigating the risk of suicidality in JFMS.
BACKGROUND: To characterize suicidality among youth with juvenile fibromyalgia syndrome (JFMS) receiving treatment from pediatric rheumatologists at a tertiary care center in order to determine the prevalence of suicidality in JFMS and to explore risk factors for persistent suicidal ideation. METHODS: We performed a cross-sectional cohort study of children 12-17 years old with JFMS seen in a specialty pediatric rheumatology pain clinic from 7/2017-9/2019. All subjects completed patient-reported outcomes measures, complemented by retrospective chart review. Subjects who endorsed item 8 on the Children's Depression Inventory, 2nd Edition (CDI-2) were categorized as endorsing suicidal ideation. We assessed for differences between the suicidal and non-suicidal patients using Wilcoxon-rank sum test. Logistic regression modeling was performed to identify psychosocial factors associated with suicidality. RESULTS: Of the 31 subjects, more than one-quarter endorsed suicidality. Nearly 90% of teens with suicidal ideation were established in outpatient counseling. In bivariate analyses, suicidality was associated with lower resilience and greater depression and anxiety (all p < 0.05). Pain intensity trended towards a statistically significant positive association (OR: 1.16 [0.99-1.37]; p = 0.06). Lower resilience was independently associated with suicidality (OR: 0.90 [95% CI: 0.82-0.98]; p < 0.02). CONCLUSIONS: Suicidality was prevalent among youth with JFMS and persistent despite concurrent receipt of mental health services. Higher patient-level resilience was independently associated with a reduced odds of suicidality. Future work should examine the role of resilience training on reducing psychological distress and mitigating the risk of suicidality in JFMS.
Authors: Cristina P Lafuente-Castro; Jorge L Ordoñez-Carrasco; Juan M Garcia-Leiva; Monika Salgueiro-Macho; Elena P Calandre Journal: Rheumatol Int Date: 2018-06-01 Impact factor: 2.631
Authors: Elena P Calandre; M Angustias Navajas-Rojas; Javier Ballesteros; Jocelyne Garcia-Carrillo; Juan M Garcia-Leiva; Fernando Rico-Villademoros Journal: Pain Pract Date: 2014-01-17 Impact factor: 3.183
Authors: Susmita Kashikar-Zuck; Irina S Parkins; Thomas Brent Graham; Anne M Lynch; Murray Passo; Megan Johnston; Kenneth N Schikler; Philip J Hashkes; Gerard Banez; Margaret M Richards Journal: Clin J Pain Date: 2008-09 Impact factor: 3.442
Authors: Irene Jimenez-Rodríguez; Juan Miguel Garcia-Leiva; Beatriz M Jimenez-Rodriguez; Emilia Condés-Moreno; Fernando Rico-Villademoros; Elena P Calandre Journal: Neuropsychiatr Dis Treat Date: 2014-04-16 Impact factor: 2.570