High impact chronic pain in children : exploration of associated characteristics and clinical factors in children and parents
Caverius, Ulla LU
; Rivano Fischer, Marcelo
LU
; Lexell, Jan
LU
and Åkerblom, Sophia
LU
(2026)
In Frontiers in Pain Research
7.
- Abstract
Background: Chronic pain in children can significantly impact daily functioning. While interdisciplinary pain rehabilitation is the recommended treatment, it is resource-intensive and limited in availability. Therefore, children with more complex symptoms, classified as High Impact Chronic Pain (HICP), need to be prioritized for interdisciplinary pain rehabilitation. However, HICP in children has been incompletely defined in previous literature, and associated factors remain underexplored. This study aimed to explore a broader biopsychosocial definition of HICP in children and to investigate characteristics and clinical factors in children and parents associated with HICP. Method: This exploratory retrospective cross-sectional registry... (More)
Background: Chronic pain in children can significantly impact daily functioning. While interdisciplinary pain rehabilitation is the recommended treatment, it is resource-intensive and limited in availability. Therefore, children with more complex symptoms, classified as High Impact Chronic Pain (HICP), need to be prioritized for interdisciplinary pain rehabilitation. However, HICP in children has been incompletely defined in previous literature, and associated factors remain underexplored. This study aimed to explore a broader biopsychosocial definition of HICP in children and to investigate characteristics and clinical factors in children and parents associated with HICP. Method: This exploratory retrospective cross-sectional registry study included 484 children with chronic pain and their parents, referred to a tertiary pediatric pain clinic in Sweden. HICP was defined using five variables: pain intensity, pain interference, overall well-being, insomnia, and school absence. Children who met thresholds in at least three of these variables were classified as having HICP. Multivariable logistic regression models were used to identify factors in children and parents associated with HICP. Results: A total of 60% of the participants met the criteria for HICP. Variables significantly associated with HICP included symptoms of depression (OR 1.10, p = 0.001) and psychological inflexibility (OR 1.06, p = 0.001) in children, as well as pain reactivity in parents (OR 1.05, p = 0.018). Conclusion: Psychiatric comorbidity and behavioral aspects, including psychological inflexibility and parental pain reactivity, play key roles in pediatric HICP and should be considered when assessing and planning interventions. Addressing these factors may improve treatment outcomes and reduce long-term challenges.
(Less)
- author
- Caverius, Ulla
LU
; Rivano Fischer, Marcelo
LU
; Lexell, Jan
LU
and Åkerblom, Sophia
LU
- organization
- publishing date
- 2026
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- adolescents, associated factors, children, functioning, high impact chronic pain, parents
- in
- Frontiers in Pain Research
- volume
- 7
- article number
- 1744974
- publisher
- Frontiers Media S. A.
- external identifiers
-
- scopus:105031508793
- pmid:41768603
- ISSN
- 2673-561X
- DOI
- 10.3389/fpain.2026.1744974
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: 2026 Caverius, Rivano Fischer, Lexell and Åkerblom.
- id
- 8f234a3a-fff5-4482-9e08-673dbe14d2bc
- date added to LUP
- 2026-04-16 13:59:13
- date last changed
- 2026-07-25 05:34:19
@article{8f234a3a-fff5-4482-9e08-673dbe14d2bc,
abstract = {{<p>Background: Chronic pain in children can significantly impact daily functioning. While interdisciplinary pain rehabilitation is the recommended treatment, it is resource-intensive and limited in availability. Therefore, children with more complex symptoms, classified as High Impact Chronic Pain (HICP), need to be prioritized for interdisciplinary pain rehabilitation. However, HICP in children has been incompletely defined in previous literature, and associated factors remain underexplored. This study aimed to explore a broader biopsychosocial definition of HICP in children and to investigate characteristics and clinical factors in children and parents associated with HICP. Method: This exploratory retrospective cross-sectional registry study included 484 children with chronic pain and their parents, referred to a tertiary pediatric pain clinic in Sweden. HICP was defined using five variables: pain intensity, pain interference, overall well-being, insomnia, and school absence. Children who met thresholds in at least three of these variables were classified as having HICP. Multivariable logistic regression models were used to identify factors in children and parents associated with HICP. Results: A total of 60% of the participants met the criteria for HICP. Variables significantly associated with HICP included symptoms of depression (OR 1.10, p = 0.001) and psychological inflexibility (OR 1.06, p = 0.001) in children, as well as pain reactivity in parents (OR 1.05, p = 0.018). Conclusion: Psychiatric comorbidity and behavioral aspects, including psychological inflexibility and parental pain reactivity, play key roles in pediatric HICP and should be considered when assessing and planning interventions. Addressing these factors may improve treatment outcomes and reduce long-term challenges.</p>}},
author = {{Caverius, Ulla and Rivano Fischer, Marcelo and Lexell, Jan and Åkerblom, Sophia}},
issn = {{2673-561X}},
keywords = {{adolescents; associated factors; children; functioning; high impact chronic pain; parents}},
language = {{eng}},
publisher = {{Frontiers Media S. A.}},
series = {{Frontiers in Pain Research}},
title = {{High impact chronic pain in children : exploration of associated characteristics and clinical factors in children and parents}},
url = {{http://dx.doi.org/10.3389/fpain.2026.1744974}},
doi = {{10.3389/fpain.2026.1744974}},
volume = {{7}},
year = {{2026}},
}