A latent profile analysis in which factors including fatigue and pain catastrophizing are evaluated may help identify subgroups of children with chronic pain and facilitate the assessment of pain functioning, according to a study published in the Journal of Pain.

The study included children with chronic pain and a primary caregiver (n=366 pairs; children aged 8 to 17 years; mean age, 14.48±2.36 years; caregivers, 94% mothers). The latent profile analysis included self-reported and parent-reported variables. The self-reported variables were fatigue, internalizing symptoms, pain catastrophizing, and pain acceptance; the parent-reported variables included pain catastrophizing and responses to child pain.

Based on these profiles, the researchers identified 4 classes of patients. Patients in class 1 (12%) had the lowest scores across 5 of 6 factors (internalizing symptoms, pain catastrophizing for self and caregiver, pain acceptance, and caregiver protective responses). Patients in classes 2 (12%) and 3 (39%) had more variability across several factors. Patients in class 2 had the lowest child fatigue, the second lowest internalizing symptoms, and the second highest levels of child and caregiver pain catastrophizing and child pain acceptance. Patients in class 3 had the second highest child fatigue and internalizing symptoms and the second lowest levels of all other variables. Patients in class 4 (37%) had the highest scores across all factors. Classes 1 and 4 had the lowest and highest risk, respectively.

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Study limitations include its preliminary and cross-sectional nature.

“Tools that allow providers to better match patient presentation and intervention are in line with the tenants of precision medicine and may serve to optimize child outcomes, family and provider burden, and healthcare savings,” noted the researchers.

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Reference

Richardson PA, Birnie KA, Harrison LE, et al. Profiling modifiable psychosocial factors among children with chronic pain: a person-centered methodology [published online September 12, 2019]. J Pain. doi:10.1016/j.jpain.2019.08.015