Assessing pain catastrophizing and functional disability in pediatric epidermolysis bullosa patients

Pediatr Dermatol. 2023 May-Jun;40(3):422-427. doi: 10.1111/pde.15220. Epub 2022 Dec 29.

Abstract

Background/objectives: The primary objective was to assess pain catastrophizing and functional disability in pediatric patients with epidermolysis bullosa (EB) and their parents/guardians. Secondary objectives included examining relationships between pain catastrophizing, functional disability, and correlations with other factors (e.g., age, disease severity, and percent of body surface area (BSA) involved).

Methods: Patients with EB ages 8-16 and their parents/guardians who were English or Spanish speaking completed a one-time online survey. Parent measures included: demographics questionnaire, Pain Catastrophizing Scale-Parent (PCS), and Parent Functional Disability Inventory (FDI). Child measures included: PCS child and child FDI. Higher scores on both scales indicate higher levels of catastrophizing and functional disability.

Results: Of 31 children, the mean age was 11.47 years and the majority (70.97%) had dystrophic EB. Mean scores were: 35.84 = PCS parent; 34.58 = PCS child; 30.87 = parent FDI; 29.77 = child FDI. Total scores for PCS parent, parent FDI, and child FDI increased significantly with disease severity and percentage of involved BSA (p < .01 for all). Total scores for PCS child increased significantly with percent of EB skin involvement (p = .04) but not disease severity. Older children reported more functional disability than their parents and younger children (p = .02).

Conclusions: Our results demonstrate significant positive correlations between negative thoughts related to pain and the experience of functional difficulties in patients with EB and their caregivers. Psychological, psychiatric, and/or behavioral interventions to help managing chronic pain may be effective for patients with EB.

Keywords: children; epidermolysis bullosa; pain; pediatric dermatology; pediatric psychology.

MeSH terms

  • Adolescent
  • Catastrophization / psychology
  • Child
  • Chronic Pain*
  • Epidermolysis Bullosa* / complications
  • Humans
  • Parents / psychology
  • Surveys and Questionnaires