(100) Long-Term Outcomes of Adolescents with Juvenile-Onset Fibromyalgia into Adulthood, and Impact of Depressive Symptoms on Functioning Over Time

Juvenile-onset fibromyalgia (JFM) is a chronic pain condition typically diagnosed in adolescence and characterized by widespread pain and marked functional impairment, including mood difficulties. However, the long-term impact of JFM during the period when adolescents transition into young adulthood is poorly understood. The objectives of this study were to describe physical and psychosocial outcomes of youth diagnosed with JFM in early adulthood (∼ 8-years after initial assessment), examine longitudinal trajectories of pain and depressive symptoms from adolescence to young adulthood, and examine the impact of pain and depressive symptoms on physical functioning over time. Participants were 97 youth with JFM enrolled in a prospective longitudinal study, in which pain symptoms, physical and psychosocial functioning were assessed at four time points over approximately eight years. The 8-year follow-up data were evaluated descriptively, and trajectories were identified using growth mixture modeling analyses in MPlus. At the final assessment (T4) (Mage = 24.2 years), a majority of young adults continued to suffer from pain and impairment in physical, social, and psychological domains, with 58% meeting ACR 2010 criteria for adult fibromyalgia (FM). However, trajectories of pain and emotional symptoms showed varying patterns. Longitudinal analyses revealed two pain trajectories (Steady Improvement and Rapid Rebounding Improvement). Depressive symptoms followed three distinct trajectories (Low-Stable, Improving, and Worsening). The group with worsening depressive symptoms was associated with poorer physical functioning over time (p < .001) compared to the Low-Stable and Improving groups. This study suggests that while JFM symptoms persist for most individuals, pain severity tends to decrease over time. However, depressive symptoms follow distinct trajectories and appear to indicate subgroups of JFM. In particular, JFM patients with worsening depressive symptoms showed decreasing physical functioning and may require more intensive and consistent intervention to prevent long-term disability. Funding was provided by NIH/NIAMS Grants R01AR054842 and K24AR056687. Juvenile-onset fibromyalgia (JFM) is a chronic pain condition typically diagnosed in adolescence and characterized by widespread pain and marked functional impairment, including mood difficulties. However, the long-term impact of JFM during the period when adolescents transition into young adulthood is poorly understood. The objectives of this study were to describe physical and psychosocial outcomes of youth diagnosed with JFM in early adulthood (∼ 8-years after initial assessment), examine longitudinal trajectories of pain and depressive symptoms from adolescence to young adulthood, and examine the impact of pain and depressive symptoms on physical functioning over time. Participants were 97 youth with JFM enrolled in a prospective longitudinal study, in which pain symptoms, physical and psychosocial functioning were assessed at four time points over approximately eight years. The 8-year follow-up data were evaluated descriptively, and trajectories were identified using growth mixture modeling analyses in MPlus. At the final assessment (T4) (Mage = 24.2 years), a majority of young adults continued to suffer from pain and impairment in physical, social, and psychological domains, with 58% meeting ACR 2010 criteria for adult fibromyalgia (FM). However, trajectories of pain and emotional symptoms showed varying patterns. Longitudinal analyses revealed two pain trajectories (Steady Improvement and Rapid Rebounding Improvement). Depressive symptoms followed three distinct trajectories (Low-Stable, Improving, and Worsening). The group with worsening depressive symptoms was associated with poorer physical functioning over time (p < .001) compared to the Low-Stable and Improving groups. This study suggests that while JFM symptoms persist for most individuals, pain severity tends to decrease over time. However, depressive symptoms follow distinct trajectories and appear to indicate subgroups of JFM. In particular, JFM patients with worsening depressive symptoms showed decreasing physical functioning and may require more intensive and consistent intervention to prevent long-term disability. Funding was provided by NIH/NIAMS Grants R01AR054842 and K24AR056687.