Chronic pain in adolescence and internalizing mental health disorders

Abstract

Chronic pain in childhood and adolescence has been shown to heighten risk for depressive and anxiety disorders in specific samples in adulthood; however, less is known about the association between a wider variety of chronic pains and internalizing mental health disorders. Using nationally representative data, the objectives of this study were to establish prevalence rates of internalizing mental health disorders (anxiety and depressive disorders) among cohorts with or without adolescent chronic pain, and to examine whether chronic pain in adolescence is associated with lifetime history of internalizing mental health disorders reported in adulthood. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) was used (N = 14,790). Individuals who had chronic pain in adolescence subsequently reported higher rates of lifetime anxiety disorders (21.1% vs. 12.4%) and depressive disorders (24.5% vs. 14.1%) in adulthood as compared to individuals without a history of adolescent chronic pain. Multivariate logistic regression confirmed that chronic pain in adolescence was associated with an increased likelihood of lifetime history of anxiety (odds ratio (OR): 1.33; 95% confidence interval (CI): 1.09-1.63, p=0.005) and depressive disorders (OR: 1.38; CI: 1.16-1.64, p<0.001) reported in adulthood. Future research is needed to examine neurobiological and psychological mechanisms underlying these co-morbidities.

Mental Health Comorbidities in Pediatric Chronic Pain: A Narrative Review of Epidemiology, Models, Neurobiological Mechanisms and Treatment

“…Findings of the most recent epidemiological study by Noel et al [18] revealed a consistent pattern. The study conducted a secondary data analysis of a sample of 14,790 individuals from the National Longitudinal Study of Adolescent to Adult Health to examine the co-occurrence of adolescent chronic pain and lifetime rates of mental health disorders [18].…”

“…Findings of the most recent epidemiological study by Noel et al [18] revealed a consistent pattern. The study conducted a secondary data analysis of a sample of 14,790 individuals from the National Longitudinal Study of Adolescent to Adult Health to examine the co-occurrence of adolescent chronic pain and lifetime rates of mental health disorders [18]. In contrast to previous research, a broader range of chronic pain conditions (i.e., headache, abdominal and musculoskeletal pain) were assessed in adolescence, and lifetime history of mental health disorders (i.e., depressive and anxiety disorders) were subsequently assessed in adulthood.…”

“…In contrast to previous research, a broader range of chronic pain conditions (i.e., headache, abdominal and musculoskeletal pain) were assessed in adolescence, and lifetime history of mental health disorders (i.e., depressive and anxiety disorders) were subsequently assessed in adulthood. Individuals with, versus without, chronic pain in adolescence subsequently reported significantly higher lifetime rates of anxiety (21.1%) and depressive (24.5%) disorders [18]. After controlling for established confounding factors (e.g., age, sex, insufficient sleep, general health), chronic pain in adolescence was associated with a greater likelihood of having anxiety (odds ratio (OR) 1.33) and depressive (OR 1.38) disorders over the lifetime [18].…”

“…Individuals with, versus without, chronic pain in adolescence subsequently reported significantly higher lifetime rates of anxiety (21.1%) and depressive (24.5%) disorders [18]. After controlling for established confounding factors (e.g., age, sex, insufficient sleep, general health), chronic pain in adolescence was associated with a greater likelihood of having anxiety (odds ratio (OR) 1.33) and depressive (OR 1.38) disorders over the lifetime [18]. …”

The influence of pain memories on children’s and adolescents’ post-surgical pain experience: A longitudinal dyadic analysis.

“…The current findings point to children’s pain memories as one potential mechanism that may underlie the persistence of pain; however, future longitudinal research is needed to further disentangle this relationship. Given the increasing prevalence (King et al, 2011) and burden (Groenewald, Wright, & Palermo, 2015) of pediatric chronic pain and its adverse impact on mental and physical health into adulthood (Noel, Groenewald, Beals-Erickson, Gebert, & Palermo, 2016; Shelby et al, 2013), this research could inform the development of cognitive-behavioral interventions to alter this course.…”