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Comment & Response
June 14, 2021

Supporting the Imperfect Use of Amplified Pain Syndrome

Author Affiliations
  • 1Division of Pain and Palliative Medicine, Connecticut Children’s Medical Center, Hartford
  • 2Department of Pediatrics, University of Connecticut School of Medicine, Farmington
  • 3Department of Anesthesiology, Hartford Hospital, Hartford, Connecticut
JAMA Pediatr. 2021;175(9):977. doi:10.1001/jamapediatrics.2021.1488

To the Editor Stigma in children with chronic pain is important because of its potential impact on health outcomes for patients and their families.1 We applaud the focus on stigma in the article by Weisman and colleagues2 but would like to share alternative views on the clinical use of the term amplified pain syndrome (APS). We agree that diagnostic labels can cause stigma, but even more problematic is how the diagnostic impression is communicated to patients and families. We argue that APS, while not perfect, provides an opportunity for clinicians to validate that the child’s pain is real and can be modulated by environmental factors.3 The dichotomy that is perpetuated in medicine is that certain health conditions, such as chronic pain, are either exclusively medical or psychological in origin, which underappreciates the biopsychosocial etiology of chronic pain. This leads to misperceptions that the patient’s pain is all in their head.

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