Elsevier

The Journal of Pain

Volume 16, Issue 10, October 2015, Pages 1054-1064
The Journal of Pain

Original Report
Comorbidity of Mental Disorders and Chronic Pain: Chronology of Onset in Adolescents of a National Representative Cohort

https://doi.org/10.1016/j.jpain.2015.06.009Get rights and content
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Highlights

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    We examined the co-occurrence of chronic pain and mental disorders in adolescents.

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    The prevalence of the co-occurrence of chronic pain and mental disorders was 25.93%.

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    All types of chronic pain were associated with mental disorders.

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    Mental disorders preceded onset of chronic pain, but not vice versa.

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    Integrative care might improve prevention and intervention for chronic pain.

Abstract

This study sought to estimate 1) the prevalence of the co-occurrence of, 2) the association between, and 3) the sequence of onset of chronic pain and mental disorders in adolescents. We used weighted data (N = 6,483) from the National Comorbidity Survey Replication Adolescent Supplement (participants' age, 13–18 years). Lifetime chronic pain was assessed by adolescent self-report; lifetime DSM-IV mental disorders were assessed by the WHO Composite International Diagnostic Interview, complemented by parent report. Among the participants in the study, 1,600 of 6,476 (25.93%) had experienced any type of chronic pain and any mental disorder in their lifetime. All types of pain were related to mental disorders. The most substantial temporal associations were those with onset of mental disorders preceding onset of chronic pain, including those between affective disorders and headaches and any chronic pain; between anxiety disorders and chronic back/neck pain, headaches, and any chronic pain; between behavior disorders and headaches and any chronic pain; and between any mental disorder and chronic back/neck pain, headaches, and any chronic pain.

Perspective

Findings indicate that affective, anxiety, and behavior disorders are early risk factors of chronic pain, thereby highlighting the relevance of child mental disorders for pain medicine. To improve prevention and interventions for chronic pain, integrative care should be considered.

Key words

Children
co-occurrence
multimorbidity
psychosomatic
somatoform

Cited by (0)

This project was financed by the Swiss National Science Foundation (SNSF) to M.T. (project no. PZ00P1_137023). In addition, M.T. and G.M. receive funding from the Korea Research Foundation within the Global Research Network Program under project no. 2013S1A2A2035364, and G.M. receives SNSF funding under project no. 100014_135328. The funding sources had no involvement in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, preview, or approval of the manuscript; or in the decision to submit this work for publication.

The National Comorbidity Survey Replication Adolescent Supplement (NCS-A) was funded by the United States Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health (U01-MH60220); United States Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse (R01-DA12058-05); United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; Robert Wood Johnson Foundation (Grant 044780); John W. Alden Trust.

The authors have no conflicts of interest to disclose.

The authors acknowledge that the original collector of the data, the Interuniversity Consortium for Political and Social Research, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such use.

Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.

Copyright © 2015 Published by Elsevier Inc.