As reported in other studies in pediatric chronic pain,
results of this study indicated that pain intensity does not
appear to be associated with school absences in children
and adolescents with JPFS. The consistent findings in the
literature that pain characteristics bear little to no relationship
with ability to participate in routine activities, such as
going to school, strongly suggest that the presence of other
factors might explain pain-related disability. Clinical
impressions and past studies (Kearney, 2008) suggest
that psychiatric comorbidity may play a role in school
absenteeism in adolescents and the current study confirmed
that a number of JPFS patients meet criteria for a
psychiatric condition. However, a current diagnosis of
depressive disorder, anxiety disorder, or attentional disorder
was not found to be associated with number of school
absences in JPFS patients. Rather, higher levels of
self-reported depressive symptoms on the CDI were significantly
associated with more school absences. However,
the amount of variance explained by depressive symptomswas modest, and the lack of significant effect of having a
diagnosis of depressive disorder was a new finding. This
lack of correspondence may be because the psychiatric
interview is an in-depth assessment conducted by a clinician
with both child and parent, and may provide a more
stringent standard for clinical depression, resulting in
fewer participants who were classified as having a current
mood disorder. Nevertheless, elevated depressive symptoms
on the CDI (regardless of whether or not a clinical
diagnosis was present) seemed to be consistently associated
with more school absences. Along with depressive
symptoms, there may be additional factors not assessed in
this study (such as peer and familial relationships, and
coping factors such as catastrophizing about pain) that
may affect school absenteeism.