Pain complaints as risk factor for mental distress: a three-year follow-up study

Abstract

The main aim of this study was to investigate the effect of pain complaints at baseline and mental distress at follow-up. We included adolescents from two longitudinal studies of 18/19 years of age with two corresponding cross-sectional baseline studies at age 15/16. A total of 5750 were invited for the baseline study, and we have 3-year follow-up data for 3316 (57.8% follow-up rate). All information is based on self-report. The questions of pain are asking for severe pain the past year. Mental distress is measured by Hopkins Symptoms Check List (HSCL-10). Number of pain sites increased among girls and decreased among boys from baseline to follow-up. There was a cross-sectional dose-response association between number of pain sites and mental distress at both time points. Also, in the follow-up study, there was dose-response relationship between numbers of pain sites at baseline and mental distress at follow-up even after controlling for possible confounding factors. We found no effect of mental distress at baseline on pain reports at follow-up. There is a strong association between pain at 15/16 years and mental distress at 18/19 years of age. Clinicians should therefore take pain complaints among adolescents seriously and be aware of comorbid and later development of mental health problems.

Musculoskeletal pain in Arctic indigenous and non-indigenous adolescents, prevalence and associations with psychosocial factors: a population-based study

“…The high prevalence of musculoskeletal pain, mental health problems, and their association is in accordance with earlier studies [2-4,9-11,16,39], with similar findings as a comparable survey done in other Norwegian counties [3,39]. A matter of concern was the high number of females with more than one pain site who reported above the clinical cut-off for anxiety/depression.…”

“…Physical complaints are associated with anxiety/depressive symptoms [1,10-13], low self-esteem, poor resilience [14], peer-, parental-, or school problems [15-18]. A dose–response association between the number of pain sites and mental health problems has been found in adolescents [3], which is similar to the general population where multiple pains are associated with depression [19]. Most studies have examined the association between physical complaints and only a few psychosocial factors.…”

Adolescents’ multiple, recurrent subjective health complaints: investigating associations with emotional/behavioural difficulties in a cross-sectional, school-based study

“…Research on paediatric community samples has shown that older children and adolescents with multiple, recurrent health complaints [9-13] –mainly headache and abdominal pains [14], as well as musculoskeletal symptoms [15] and fatigue [16]– have an amplified risk to experience anxiety and depressive symptoms. The above outcomes have been corroborated by longitudinal research evidence [5,17-23], even though not consistently [12,23-25]. Regarding the associations of SHC with externalizing symptoms and disorders, such as hyperactivity/inattention, conduct problems and difficulties in social interactions, research so far has been less extensive and less conclusive in its findings.…”

“…Increasing numbers of SHC have been associated with higher levels of anxiety and depressive symptoms, as well as of externalizing symptoms, signaling a shift of research focus from specific types of symptoms to the number and frequency of co-occurring symptoms [12,21,23,35]. Against this background, presentations of multiple, recurrent SHC in paediatric primary care services could foster the early identification of individuals with an elevated risk for emotional/behavioural problems and, thus, represent a viable window for timely mental health interventions.…”

Multisite musculoskeletal pain in adolescence as a predictor of medical and social welfare benefits in young adulthood: The Norwegian Arctic Adolescent Health Cohort Study

“…Musculoskeletal pain is a common complaint in adolescents (King et al, 2011;Mangerud et al, 2013;Eckhoff and Kvernmo, 2014), and adolescent multisite pain is more associated with mental health problems than single-site pain (Hoftun et al, 2011;Lien et al, 2011;Eckhoff and Kvernmo, 2014;Skrove et al, 2015). Adolescent musculoskeletal pain is associated with mood and anxiety disorders (Mangerud et al, 2013;Shanahan et al, 2015;Eckhoff et al, 2017), the most prevalent mental health disorders resulting in long-term medical benefits in Norway (Bragstad and Brage, 2011).…”