[Pain-related disability in adolescents suffering from chronic pain. Preliminary examination of the Pediatric Pain Disability Index (P-PDI)]. / Schmerzbezogene Beeinträchtigung bei Jugendlichen mit chronischen Schmerzen. Erste Uberprüfung des Pediatric Pain Disability Index (P-PDI).

BACKGROUND: Pain-related disability affects many children and adolescents suffering from chronic pain and may exert an impact on all areas of their lives. Reduction of pain-related disability is, therefore, a fundamental aim of treatment; however, no validated means exist to assess pain-related disability in children and adolescents. The aim of this study was to translate the Pediatric Pain Disability Index (P-PDI) of Varni into German and to investigate its psychometric qualities. METHODS: Principal component and item analyses were conducted on outpatient (n=163) and inpatient samples (n=167) of adolescents suffering from chronic pain. Changes in pain-related disability 3 months after starting treatment were analysed in an outpatient sample of 110 adolescents. Correlations between pain-related disability, emotional variables and school absence as well as concordance with parents' ratings were investigated. RESULTS: The P-PDI is a one-dimensional assessment tool with sufficient reliability. There were significant correlations between pain-related disability and pain intensity and school absence but not with pain duration, fear and depression. Parents and adolescents ratings correlated significantly, but 57% of parents underestimated the pain-related disability of their children. CONCLUSION: There is now a validated German version of the P-PDI to measure pain-related disability in adolescents suffering from chronic pain, which can be used in studies investigating treatment effectiveness.

[Three-week multimodal inpatient treatment of children with chronic pain. First results of the long-term follow-up]. / Dreiwöchige stationäre multimodale Schmerztherapie bei Kindern und Jugendlichen mit chronischen Schmerzen. Erste Ergebnisse in der Langzeitwirkung.

OBJECTIVE: In children and adolescents we investigated the impact of a 3-week inpatient multimodal pain therapy on subjective burden of life, pain intensity, and number of days off from school 3, 6, or 12 months later. METHODS: At the beginning of therapy (inpatient setting) and 3, 6, and 12 months thereafter (outpatient setting) we collected the respective data using standardized questionnaires. For statistical analysis we used Wilcoxon's signed rank test. A p <0.05 was regarded as statistically significant. RESULTS: A total of 72 patients aged 7.5-18.2 years suffering daily pain entered the study, most of them being diagnosed with somatoform pain disease. After 3, 6, and 12 months, 65, 27, and 30 patients could be reevaluated. Mean pain intensity of the week before data acquisition was significantly less than at the beginning (2.9, 2.3, and 2.9 vs 6.3) as was the mean number of days off from school due to pain during the 4-week period before each day of data acquisition (1.8, 1.5, and 1.4 vs 9.2). Mean subjective burden of life was significantly less than at the beginning (24.5, 22.0, and 25.8 vs 37.8). CONCLUSION: Outpatient multimodal pain therapy has a sustained impact on children and adolescents suffering from chronic pain.

[Recurrent abdominal pain]. / Rezidivierende Bauchschmerzen.

BACKGROUND: Recurrent abdominal pain is found in 10-25% of school-aged children, thus being one of the most frequent complaints in childhood. Despite that, our knowledge about this syndrome is still very incomplete. DIAGNOSIS AND THERAPY: In the majority of cases, the traditional diagnostic approach understanding abdominal pain as a symptom of an underlying organic or psychological disease does not lead to a well-defined diagnosis with straightforward therapy. The natural course of abdominal pain in childhood seems to be less favorable than often assumed. Modern biopsychosocial models of recurrent abdominal pain are presented as a basis for future multimodal therapeutic concepts.