{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:09:48Z","timestamp":1791950988512,"version":"4.3.4"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Rheumatol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Only a small percentage of pediatric chest pain is of cardiac origin and the most common detected cause is musculoskeletal. Among musculoskeletal causes, acute chest pain is better described, with the causes of chronic pain not being adequately investigated in the literature. The aim of studuy is to evaluate the musculoskeletal causes of non-cardiac chest pain and investigate the relationship of chest pain with child abuse and central sensitization.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients aged 12 to 18\u2009years presenting with chest pain for at least 3 months were evaluated by a pediatric cardiologist and those without an organic pathology were referred to the physical medicine and rehabilitation clinic. In addition to detailed history and physical examination, juvenile fibromyalgia was questioned according to the 2016 revised diagnostic criteria of the American College of Rheumatology. The visual analog scale (to measure intensity of chest pain), the Central Sensitization Inventory (to evaluate the presence of central sensitization), the Hospital Anxiety Depression Scale (to determine depression and anxiety), the Childhood Trauma Questionnaire (to assess the presence of child abuse) were administered.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The study was completed with 64 patients. Twenty-six percent of patient (<jats:italic>n<\/jats:italic>\u2009=\u200917) were diagnosed with juvenile fibromyalgia, and central sensitization was detected in 34.4% (<jats:italic>n<\/jats:italic>\u2009=\u200922). Pain intensity, anxiety, depression and abuse scores were higher in patients with juvenile fibromyalgia than those without juvenile fibromyalgia and in patients with central sensitization compared to those without central sensitization (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 for both). Higher scores of pain were related with child abuse [beta\u2009=\u20090.763, p\u2009&lt;\u20090.001, (%95 CI, 4.397; 8.841)] and central sensitization of pain [beta\u2009=\u20090.382, <jats:italic>p<\/jats:italic>\u2009=\u20090.008 (95% CI: (0.986;6.231)] in regression analyses.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In this study, juvenile fibromyalgia was detected as a cause of non-cardiac chest pain. Juvenile fibromyalgia or central sensitization may also indicate childhood abuse.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12969-020-00421-0","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T11:03:11Z","timestamp":1585652591000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["A preliminary study of the child abuse and central sensitization in adolescent patients with chronic non-organic chest pain and an overlooked condition: juvenile fibromyalgia syndrome"],"prefix":"10.1186","volume":"18","author":[{"given":"Basak","family":"Mansiz-Kaplan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Figen","family":"Ayhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihriban","family":"Cagli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Atik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim","family":"Ece","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,31]]},"reference":[{"issue":"12","key":"421_CR1","doi-asserted-by":"publisher","first-page":"e274","DOI":"10.3928\/00904481-20151110-01","volume":"44","author":"TK Yeh","year":"2015","unstructured":"Yeh TK, Yeh J. Chest pain in pediatrics. Pediatr Ann. 2015;44(12):e274\u20138.","journal-title":"Pediatr Ann"},{"issue":"5","key":"421_CR2","doi-asserted-by":"publisher","first-page":"e1062","DOI":"10.1542\/peds.2011-0408","volume":"128","author":"SF Saleeb","year":"2011","unstructured":"Saleeb SF, Li WY, Warren SZ, Lock JE. Effectiveness of screening for life-threatening chest pain in children. Pediatrics. 2011;128(5):e1062\u20138.","journal-title":"Pediatrics"},{"key":"421_CR3","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.pcl.2008.10.001","volume":"56","author":"J Gokhale","year":"2009","unstructured":"Gokhale J, Selbst SM. Chest pain and chest wall deformity. Pediatr Clin N Am. 2009;56:49\u201365.","journal-title":"Pediatr Clin N Am"},{"issue":"3","key":"421_CR4","doi-asserted-by":"publisher","first-page":"295","DOI":"10.24953\/turkjped.2017.03.010","volume":"59","author":"A Daskapan","year":"2017","unstructured":"Daskapan A, Sanli C, Aydogan-Arslan S, Ciledag-Ozdemir F, Korkem D, Kara U. Evaluation of the functional capacity, respiratory functions and musculoskeletal systems of the children with chest pain for non-cardiac reasons. Turk J Pediatr. 2017;59(3):295\u2013303.","journal-title":"Turk J Pediatr"},{"issue":"3","key":"421_CR5","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.spen.2016.10.007","volume":"23","author":"L Zemel","year":"2016","unstructured":"Zemel L, Blier PR. Juvenile fibromyalgia: a primary pain, or pain processing. Disorder Semin Pediatr Neurol. 2016;23(3):231\u201324.","journal-title":"Disorder Semin Pediatr Neurol"},{"issue":"2","key":"421_CR6","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1038\/nrrheum.2013.177","volume":"10","author":"S Kashikar-Zuck","year":"2014","unstructured":"Kashikar-Zuck S, Ting TV. Juvenile fibromyalgia: current status of research and future developments. Nat Rev Rheumatol. 2014;10(2):89\u201396.","journal-title":"Nat Rev Rheumatol"},{"issue":"1","key":"421_CR7","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.rbr.2015.07.008","volume":"56","author":"R Goulart","year":"2016","unstructured":"Goulart R, Pessoa C, Junior IM. Psychological aspects of juvenile fibromyalgia syndrome: a literature review. Rev Bras Reumatol Engl Ed. 2016;56(1):69\u201374.","journal-title":"Rev Bras Reumatol Engl Ed"},{"issue":"8","key":"421_CR8","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.chiabu.2011.04.007","volume":"35","author":"GD Eslick","year":"2011","unstructured":"Eslick GD, Koloski NA, Talley NJ. Sexual, physical, verbal\/emotional abuse and unexplained chest pain. Child Abuse Negl. 2011;35(8):601\u20135.","journal-title":"Child Abuse Negl"},{"key":"421_CR9","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.jpeds.2010.07.021","volume":"158","author":"B Smits-Engelsman","year":"2011","unstructured":"Smits-Engelsman B, Klerks M, Kirby A. Beighton score: a valid measure for generalized hypermobility in children. J Pediatr. 2011;158:119\u201323.","journal-title":"J Pediatr"},{"issue":"3","key":"421_CR10","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","volume":"46","author":"F Wolfe","year":"2016","unstructured":"Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 revision to the 2010\/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016;46(3):319\u201329.","journal-title":"Semin Arthritis Rheum"},{"key":"421_CR11","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.jpeds.2015.10.011","volume":"169","author":"TV Ting","year":"2016","unstructured":"Ting TV, Barnett K, Lynch-Jordon A, et al. 2010 American College of Rheumatology adult fibromyalgia criteria for use in an adolescant female population with juvenile fibromyalgia. J Pediatr. 2016;169:181\u20137.","journal-title":"J Pediatr"},{"issue":"5","key":"421_CR12","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1016\/j.jpain.2012.11.012","volume":"14","author":"R Nebblett","year":"2013","unstructured":"Nebblett R, Cohen H, Choi Y, et al. The central sensitization inventory (CSI): establidhing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. J Pain. 2013;14(5):438\u201345.","journal-title":"J Pain"},{"key":"421_CR13","volume-title":"Validity and reliability of the Turkish version of the central sensitization inventory in Turkish. PM&R Speciality Thesis","author":"E Duzce","year":"2017","unstructured":"Duzce E, Birtane M. Validity and reliability of the Turkish version of the central sensitization inventory in Turkish. PM&R Speciality Thesis. Edirne: Trakya University School of Medicine; 2017. Unpublished thesis."},{"key":"421_CR14","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","volume":"67","author":"AS Zigmond","year":"1983","unstructured":"Zigmond AS, Snaith RP. The hospital anxiety depression scale. Acta Psychiatr Scand. 1983;67:361\u201370.","journal-title":"Acta Psychiatr Scand"},{"issue":"4","key":"421_CR15","first-page":"280","volume":"8","author":"O Aydemir","year":"1997","unstructured":"Aydemir O, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version hospital anxiety and depression scale. Turk Psikiyatri Derg. 1997;8(4):280\u20137.","journal-title":"Turk Psikiyatri Derg"},{"key":"421_CR16","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/00004583-199701000-00004","volume":"36","author":"DP Bernstein","year":"1997","unstructured":"Bernstein DP, Ahluvalia T, Pogge D, Handelsman L. Valitidy of the childhood trauma questionnaire in an adolescent psychiatric population. J Am Acad Child Adolesc Psychiatry. 1997;36:3.","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"2","key":"421_CR17","first-page":"275","volume":"10","author":"SH Aslan","year":"1999","unstructured":"Aslan SH, Alparslan ZN. The reliability, validity and factor structure of the childhood trauma Questionnare among a group of university students. Turk Psikiyatri Derg. 1999;10(2):275\u201385.","journal-title":"Turk Psikiyatri Derg"},{"issue":"3","key":"421_CR18","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.jpsychores.2005.05.004","volume":"59","author":"JD Lipsitz","year":"2005","unstructured":"Lipsitz JD, Masia C, Apfel H, et al. Noncardiac chest pain and psychopathology in children and adolescents. J Psychosom Res. 2005;59(3):185\u20138.","journal-title":"J Psychosom Res"},{"key":"421_CR19","first-page":"1","volume":"16","author":"Z Khairandish","year":"2016","unstructured":"Khairandish Z, Jamail L, Haghbin S. Role of anxiety and depression in adolescents with chest pain referred to a cardiology clinic. Cardiol Young. 2016;16:1\u20136.","journal-title":"Cardiol Young"},{"key":"421_CR20","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1017\/S1047951116002109","volume":"27","author":"K Eliacik","year":"2017","unstructured":"Eliacik K, Kanik A, Bolat N, et al. Anxiety, depression, suicidal ideation, and stressful life events in non-cardiac adolescent chest pain: a comparative study about the hidden part of the iceberg. Cardiol Young. 2017;27:1098\u2013103.","journal-title":"Cardiol Young"},{"issue":"10","key":"421_CR21","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1017\/S1047951119001896","volume":"29","author":"A Kenar","year":"2019","unstructured":"Kenar A, Orun UA, Yoldas T, Kayal\u0131 S, Bodur S, Karademir S. Anksiety, depression, and behavioural rating scales in children with non-cardiac chest pain. Cardiol Young. 2019;29(10):1268\u201371.","journal-title":"Cardiol Young"},{"key":"421_CR22","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.semarthrit.2006.12.009","volume":"36","author":"MB Yunus","year":"2007","unstructured":"Yunus MB. Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum. 2007;36:339\u201356.","journal-title":"Semin Arthritis Rheum"},{"issue":"7","key":"421_CR23","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1097\/AJP.0000000000000444","volume":"33","author":"CD King","year":"2017","unstructured":"King CD, Jastrowski Mano KE, Barnett KA, et al. Pressure pain threshold and anxiety in adolescent females with and without juvenile fibromyalgia: a pilot study. Clin J Pain. 2017;33(7):620\u20136.","journal-title":"Clin J Pain"},{"issue":"2","key":"421_CR24","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1002\/ejp.1140","volume":"22","author":"L Arendt-Nielsen","year":"2018","unstructured":"Arendt-Nielsen L, Morlion B, Perrot S, et al. Assessment and manifestation of central sensitisation across different chronic pain conditions. Eur J Pain. 2018;22(2):216\u201341.","journal-title":"Eur J Pain"},{"issue":"12","key":"421_CR25","doi-asserted-by":"publisher","first-page":"2427","DOI":"10.3899\/jrheum.141369","volume":"42","author":"NR Cunnigham","year":"2015","unstructured":"Cunnigham NR, Tran ST, Lynch-Jordon A, et al. Psychiatric disorders in young adults diagnosed with juvenile fibromyalgia in adolescence. J Rheumatol. 2015;42(12):2427\u201333.","journal-title":"J Rheumatol"},{"issue":"5","key":"421_CR26","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1097\/01.ajp.0000149795.08746.31","volume":"21","author":"DA Davis","year":"2005","unstructured":"Davis DA, Luecken LJ, Zautra AJ. Are reports of childhood abuse related to the experience of chronic pain in adulthood? A meta-analytic review of the literature. Clin J Pain. 2005;21(5):398\u2013405.","journal-title":"Clin J Pain"},{"issue":"4","key":"421_CR27","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/S0022-3999(02)00399-9","volume":"54","author":"A Lampe","year":"2003","unstructured":"Lampe A, Doering S, Rumpold G, et al. Chronic pain syndromes and their relation to childhood abuse and stressful life events. J Psychosom Res. 2003;54(4):361\u20137.","journal-title":"J Psychosom Res"},{"issue":"1","key":"421_CR28","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1097\/j.pain.0000000000001706","volume":"161","author":"SJ Beal","year":"2019","unstructured":"Beal SJ, Kashikar-Zuck S, King C, et al. Heightened risk of pain in young adult women with a history of childhood maltreatment: a prospective longitudinal study. Pain. 2019;161(1):156. https:\/\/doi.org\/10.1097\/j.pain.0000000000001706.","journal-title":"Pain"},{"issue":"6","key":"421_CR29","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1002\/acr.20328","volume":"63","author":"W H\u00e4user","year":"2011","unstructured":"H\u00e4user W, Kosseva M, \u00dcceyler N, et al. Emotional, physical, and sexual abuse in fibromyalgia syndrome: a systematic review with meta-analysis. Arthritis Care Res. 2011;63(6):808\u201320.","journal-title":"Arthritis Care Res"},{"key":"421_CR30","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.jpsychores.2017.06.011","volume":"99","author":"A Varinen","year":"2017","unstructured":"Varinen A, Kosunen E, Mattila K, et al. The relationship between childhood adversities and fibromyalgia in the general population. J Psychosom Res. 2017;99:137\u201342.","journal-title":"J Psychosom Res"},{"key":"421_CR31","doi-asserted-by":"publisher","first-page":"3865249","DOI":"10.1155\/2017\/3865249","volume":"2017","author":"R Hellou","year":"2017","unstructured":"Hellou R, H\u00e4user W, Brenner I, et al. Self-reported childhood maltreatment and traumatic events among Israeli patients suffering from fibromyalgia and rheumatoid arthritis. Pain Res Manag. 2017;2017:3865249.","journal-title":"Pain Res Manag"},{"issue":"4","key":"421_CR32","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1515\/IJAMH.2009.21.4.571","volume":"21","author":"K Lommel","year":"2009","unstructured":"Lommel K, Kapoor S, Bamford J, et al. Juvenile primary fibromyalgia syndrome in an inpatient adolescent psychiatric population. Int J Adolesc Med Health. 2009;21(4):571\u20139.","journal-title":"Int J Adolesc Med Health"}],"container-title":["Pediatric Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12969-020-00421-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12969-020-00421-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12969-020-00421-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T23:14:08Z","timestamp":1617146048000},"score":1,"resource":{"primary":{"URL":"https:\/\/ped-rheum.biomedcentral.com\/articles\/10.1186\/s12969-020-00421-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,31]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["421"],"URL":"https:\/\/doi.org\/10.1186\/s12969-020-00421-0","relation":{},"ISSN":["1546-0096"],"issn-type":[{"value":"1546-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,31]]},"assertion":[{"value":"30 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 March 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 March 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national guidelines on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008, and has been approved by the Institutional Review Board. The study was approved by the ethics committee of the tertiary care hospital. Written consent was obtained from all children who participated in the study and their parents.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent was obtained from all children who participated in the study and their parents for publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"28"}}