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Chronic pain in adolescence and internalizing mental health disorders: a nationally representative study

Noel, Melanie; Groenewald, Cornelius B.; Beals-Erickson, Sarah E.; Gebert, J. Thomas; Palermo, Tonya M.

doi: 10.1097/j.pain.0000000000000522
Research Paper

Chronic pain in childhood and adolescence has been shown to heighten the risk for depressive and anxiety disorders in specific samples in adulthood; however, little 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 with 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 disorders (odds ratio: 1.33; 95% confidence interval: 1.09-1.63, P = 0.005) and depressive disorders (odds ratio: 1.38; confidence interval: 1.16-1.64, P < 0.001) reported in adulthood. Future research is needed to examine neurobiological and psychological mechanisms underlying these comorbidities.

Using a nationally representative longitudinal data set, chronic pain in adolescence was associated with heightened risk for lifetime anxiety and depressive disorders reported in adulthood.

aDepartment of Psychology, University of Calgary and Alberta Children's Hospital Research Institute, Calgary, AB, Canada

bSeattle Children's Research Institute, Seattle, WA, USA

cDepartment of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA

dDepartment of Neurobiology, University of Washington, College of Arts and Sciences, and School of Medicine, Seattle, WA, USA

Departments of eAnesthesiology,

fPediatrics, and

gPsychiatry, University of Washington, Seattle, WA, USA

Corresponding author. Address: Department of Psychology, University of Calgary and Alberta Children's Hospital Research Institute, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada. Tel.: 403-477-1162. E-mail address: (M. Noel).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received October 28, 2015

Received in revised form January 26, 2016

Accepted February 08, 2016

© 2016 International Association for the Study of Pain
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