The Relationship Between Chronic Pain, Depression, Psychosocial Factors, and Suicidality in Adolescents

Abstract

Background: Chronic pain in youth is often associated with social conflict, depression, and suicidality. The interpersonal theory of suicide posits that there are psychosocial factors, such as peer victimization and lack of fear of pain, that may also influence suicidality. Objectives: The objective of this study was to determine whether depressive symptoms, peer victimization, and lack of fear of pain predict suicidality in adolescents with chronic pain. It was hypothesized that higher levels of depressive symptoms and peer victimization, and lower levels of fear of pain, would predict a higher lifetime prevalence of suicidality. Methods: Participants consisted of 184 youth with primary chronic pain conditions (10 to 18 y, M = 14.27 y). Measures included diagnostic clinical interviews assessing suicidality and self-report questionnaires assessing depressive symptoms, peer victimization, and fear of pain. Results: Forty-two (22.8%) participants reported suicidality. Regression analyses demonstrated that the occurrence of suicidality was associated with higher rates of depressive symptoms (β = 1.03, P = 0.020, 95% CI: 1.01, 1.06) and peer victimization (β = 2.23, P < 0.05, 95% CI: 1.07, 4.63), though there was no association between lower fear of pain and suicidality. Discussion: These results suggest that depressive symptoms and peer victimization are significant predictors of suicidality in adolescents with chronic pain; however, lower fear of pain was not shown to be a significant predictor. Given these findings, depression and peer victimization should be further explored and considered in the design and implementation of prevention and early intervention strategies that target chronic pain and suicidality in youth.

Balance Disorders and Pain: An Analysis Based on the 2003-2004 NHANES Survey After Propensity Score Matching.

“…Therefore, the pain questionnaire in the [2003][2004] National Health and Nutrition Examination Survey (NHANES) directly states, "This is of importance because of the increasing morbidity and mortality associated with balance disorders among older persons in the U.S." Pain is a prevalent condition that affects more than 100 million adults in the United States, making it one of the leading causes of health problems worldwide. 4,5 Pain can be caused by various diseases, and its effects on the body are multifaceted, affecting not only physical health but also mental health 6,7 . It has been suggested that dizziness, psychological disorders, and pain should be considered multifaceted, interacting, and interfering problems 8 .…”