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BMC Psychiatry
Published in: BMC Psychiatry 1/2013

Open Access 01-12-2013 | Research article

Chronic pain and pain-related disability across psychiatric disorders in a clinical adolescent sample

Authors: Wenche L Mangerud, Ottar Bjerkeset, Stian Lydersen, Marit S Indredavik

Published in: BMC Psychiatry | Issue 1/2013

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Abstract

Background

People who suffer from psychiatric disorders are burdened with a high prevalence of chronic illnesses and pain, but evidence on pain prevalence among adolescents with psychiatric disorders is scarce. The aim of this study was to investigate the frequency and location of self-reported chronic pain and pain-related disability in adolescent psychiatric patients.

Methods

This study was part of the larger Health Survey administered at the Department of Child and Adolescent Psychiatry (CAP) at St. Olav’s University Hospital, in Trondheim, Norway. All patients aged 13–18 years who visited the CAP clinic at least once between February 15, 2009 and February 15, 2011 were invited to participate. A total of 717 (43.5% of eligible/invited patients) participated; of these, 566 were diagnosed with one or more psychiatric disorders. The adolescents completed a questionnaire, which included questions about pain and pain-related disability. Clinical diagnoses were classified by a clinician according to International Statistical Classification of Diseases and Related Health Problems, 10th revision criteria.

Results

In adolescents with psychiatric disorders, 70.4% reported chronic pain, and 37.3% experienced chronic pain in three or more locations (multisite pain). Chronic musculoskeletal pain was the most prevalent type of pain (57.7%). Pain-related disability was found in 22.2% of the sample. The frequency of chronic pain and multisite pain increased with age, and girls reported a higher frequency of chronic pain, multisite pain and pain-related disability than boys did. There was an increased risk of chronic pain among adolescents with mood or anxiety disorders versus those with hyperkinetic disorders, yet this was not present after adjusting for sex. Comorbidity between hyperkinetic and mood or anxiety disorders involved an increased risk of pain-related disability.

Conclusions

In this study, seven out of 10 adolescents with psychiatric disorders reported chronic pain. These findings indicate the importance of early detection of chronic pain in adolescents with psychiatric disorders, to provide targeted treatment and reduce poor long-term outcomes.
Appendix
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Literature
1.
Mykletun A, Knudsen AK, Mathiesen KS: Psykiske lidelser i norge: Et folkehelseperspektiv. [Mental disorders in norway: a public health perspective]. 2009, Oslo: Norwegian Institute of Public Health
2.
McWilliams LA, Cox BJ, Enns MW: Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain. 2003, 106: 127-133. 10.1016/S0304-3959(03)00301-4.CrossRefPubMed
3.
Bair MJ, Robinson RL, Katon W, Kroenke K: Depression and pain comorbidity: a literature review. Arch Intern Med. 2003, 163: 2433-2445. 10.1001/archinte.163.20.2433.CrossRefPubMed
4.
Means-Christensen AJ, Roy-Byrne PP, Sherbourne CD, Craske MG, Stein MB: Relationships among pain, anxiety, and depression in primary care. Depress Anxiety. 2008, 25: 593-600. 10.1002/da.20342.CrossRefPubMed
5.
Katona C, Peveler R, Dowrick C, Wessely S, Feinmann C, Gask L, Lloyd H, Williams AC, Wager E: Pain symptoms in depression: definition and clinical significance. Clin Med. 2005, 5: 390-395. 10.7861/clinmedicine.5-4-390.CrossRef
6.
7.
King S, Chambers CT, Huguet A, MacNevin RC, McGrath PJ, Parker L, MacDonald AJ: The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain. 2011, 152: 2729-2738. 10.1016/j.pain.2011.07.016.CrossRefPubMed
8.
Rustoen T, Wahl AK, Hanestad BR, Lerdal A, Paul S, Miaskowski C: Prevalence and characteristics of chronic pain in the general Norwegian population. Eur J Pain. 2004, 8: 555-565. 10.1016/j.ejpain.2004.02.002.CrossRefPubMed
9.
Rustoen T, Wahl AK, Hanestad BR, Lerdal A, Paul S, Miaskowski C: Gender differences in chronic pain–findings from a population-based study of Norwegian adults. Pain Manag Nurs. 2004, 5: 105-117. 10.1016/j.pmn.2004.01.004.CrossRefPubMed
10.
Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL: Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009, 10: 447-485.CrossRefPubMedPubMedCentral
11.
Nicolson SE, Caplan JP, Williams DE, Stern TA: Comorbid pain, depression, and anxiety: multifaceted pathology allows for multifaceted treatment. Harv Rev Psychiatry. 2009, 17: 407-420. 10.3109/10673220903463226.CrossRefPubMed
12.
Hoftun GB, Romundstad PR, Zwart JA, Rygg M: Chronic idiopathic pain in adolescence–high prevalence and disability: the young HUNT study 2008. Pain. 2011, 152: 2259-2266. 10.1016/j.pain.2011.05.007.CrossRefPubMed
13.
Campo JV, Comer DM, Jansen-Mcwilliams L, Gardner W, Kelleher KJ: Recurrent pain, emotional distress, and health service use in childhood. J Pediatr. 2002, 141: 76-83. 10.1067/mpd.2002.125491.CrossRefPubMed
14.
DeSocio J, Hootman J: Children’s mental health and school success. J Sch Nurs. 2004, 20: 189-196. 10.1177/10598405040200040201.CrossRefPubMed
15.
WHO: The ICD-10 Classification of Mental and Behavioural Disorders, Clinical Description and Diagnostic Guidelines. 1992, Geneva: World Health Organization
16.
Mikkelsson M, Salminen JJ, Kautiainen H: Non-specific musculoskeletal pain in preadolescents. Prevalence and 1-year persistence. Pain. 1997, 73: 29-35. 10.1016/S0304-3959(97)00073-0.CrossRefPubMed
17.
Mikkelsson M, Salminen JJ, Sourander A, Kautiainen H: Contributing factors to the persistence of musculoskeletal pain in preadolescents: a prospective 1-year follow-up study. Pain. 1998, 77: 67-72. 10.1016/S0304-3959(98)00083-9.CrossRefPubMed
18.
Knook LM, Lijmer JG, Konijnenberg AY, Taminiau B, van Engeland H: The course of chronic pain with and without psychiatric disorders: a 6-year follow-up study from childhood to adolescence and young adulthood. J Clin Psychiatry. 2012, 73: e134-e139. 10.4088/JCP.10m06751.CrossRefPubMed
19.
Sharp J, Keefe B: Psychiatry in chronic pain: a review and update. Curr Psychiatry Rep. 2005, 7: 213-219. 10.1007/s11920-005-0056-x.CrossRefPubMed
20.
Lindsay PG, Wyckoff M: The depression-pain syndrome and its response to antidepressants. Psychosomatics. 1981, 22: 571–573-576–577.CrossRefPubMed
21.
Goldenberg DL: Pain/depression dyad: a key to a better understanding and treatment of functional somatic syndromes. Am J Med. 2010, 123: 675-682. 10.1016/j.amjmed.2010.01.014.CrossRefPubMed
22.
Gambassi G: Pain and depression: the egg and the chicken story revisited. Arch Gerontol Geriatr. 2009, 49 (Suppl 1): 103-112.CrossRefPubMed
23.
Asmundson GJ, Katz J: Understanding the co-occurrence of anxiety disorders and chronic pain: state-of-the-art. Depress Anxiety. 2009, 26: 888-901. 10.1002/da.20600.CrossRefPubMed
24.
Sharp TJ, Harvey AG: Chronic pain and posttraumatic stress disorder: mutual maintenance?. Clin Psychol Rev. 2001, 21: 857-877. 10.1016/S0272-7358(00)00071-4.CrossRefPubMed
25.
Asmundson GJ, Coons MJ, Taylor S, Katz J: PTSD and the experience of pain: research and clinical implications of shared vulnerability and mutual maintenance models. Can J Psychiatry. 2002, 47: 930-937.PubMed
26.
27.
Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA, Bohnen AM, van Suijlekom-Smit LW, Passchier J, van der Wouden JC: Pain in children and adolescents: a common experience. Pain. 2000, 87: 51-58. 10.1016/S0304-3959(00)00269-4.CrossRefPubMed
28.
Fernandez-de-las-Penas C, Hernandez-Barrera V, Alonso-Blanco C, Palacios-Cena D, Carrasco-Garrido P, Jimenez-Sanchez S, Jimenez-Garcia R: Prevalence of neck and low back pain in community-dwelling adults in Spain: a population-based national study. Spine (Phila Pa 1976). 2011, 36: E213-E219. 10.1097/BRS.0b013e3181d952c2.CrossRef
29.
Antonaci F, Nappi G, Galli F, Manzoni GC, Calabresi P, Costa A: Migraine and psychiatric comorbidity: a review of clinical findings. J Headache Pain. 2011, 12: 115-125. 10.1007/s10194-010-0282-4.CrossRefPubMedPubMedCentral
30.
O’Sullivan P, Beales D, Jensen L, Murray K, Myers T: Characteristics of chronic non-specific musculoskeletal pain in children and adolescents attending a rheumatology outpatients clinic: a cross-sectional study. Pediatr Rheumatol Online J. 2011, 9: 3-10.1186/1546-0096-9-3.CrossRefPubMedPubMedCentral
31.
Di Lorenzo C, Colletti RB, Lehmann HP, Boyle JT, Gerson WT, Hyams JS, Squires RH, Walker LS, Kanda PT, Subcommittee AAP, Pain NCoCA: Chronic abdominal pain in children: a technical report of the American academy of pediatrics and the North American society for pediatric gastroenterology, hepatology and nutrition. J Pediatr Gastroenterol Nutr. 2005, 40: 249-261. 10.1097/01.MPG.0000154661.39488.AC.CrossRefPubMed
32.
Maizels M, Aurora S, Heinricher M: Beyond neurovascular: migraine as a dysfunctional neurolimbic pain network. Headache. 2012, 52: 1553-1565. 10.1111/j.1526-4610.2012.02209.x.CrossRefPubMed
33.
D’Andrea G, Ostuzzi R, Francesconi F, Musco F, Bolner A, D’Onofrio F, Colavito D: Migraine prevalence in eating disorders and pathophysiological correlations. Neurol Sci. 2009, 30 (1): S55-S59. 10.1007/s10072-008-0003-9.CrossRefPubMed
34.
Dorn LD, Campo JC, Thato S, Dahl RE, Lewin D, Chandra R, Di Lorenzo C: Psychological comorbidity and stress reactivity in children and adolescents with recurrent abdominal pain and anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2003, 42: 66-75. 10.1097/00004583-200301000-00012.CrossRefPubMed
35.
Dufton LM, Dunn MJ, Compas BE: Anxiety and somatic complaints in children with recurrent abdominal pain and anxiety disorders. J Pediatr Psychol. 2009, 34: 176-186.CrossRefPubMed
36.
Weiselberg EC, Gonzalez M, Fisher M: Eating disorders in the twenty-first century. Minerva Ginecol. 2011, 63: 531-545.PubMed
37.
38.
Huguet A, Miro J: The severity of chronic pediatric pain: an epidemiological study. J Pain. 2008, 9: 226-236. 10.1016/j.jpain.2007.10.015.CrossRefPubMed
39.
Konijnenberg AY, Uiterwaal CS, Kimpen JL, van der Hoeven J, Buitelaar JK, de Graeff-Meeder ER: Children with unexplained chronic pain: substantial impairment in everyday life. Arch Dis Child. 2005, 90: 680-686. 10.1136/adc.2004.056820.CrossRefPubMedPubMedCentral
40.
Petersen S, Hagglof BL, Bergstrom EI: Impaired health-related quality of life in children with recurrent pain. Pediatrics. 2009, 124: e759-e767. 10.1542/peds.2008-1546.CrossRefPubMed
41.
Roth-Isigkeit A, Thyen U, Stoven H, Schwarzenberger J, Schmucker P: Pain among children and adolescents: restrictions in daily living and triggering factors. Pediatrics. 2005, 115: e152-e162. 10.1542/peds.2004-0682.CrossRefPubMed
42.
Hall AM, Kamper SJ, Maher CG, Latimer J, Ferreira ML, Nicholas MK: Symptoms of depression and stress mediate the effect of pain on disability. Pain. 2011, 152: 1044-1051. 10.1016/j.pain.2011.01.014.CrossRefPubMed
43.
Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC: The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007, 133: 581-624.CrossRefPubMed
44.
Petersen S, Brulin C, Bergstrom E: Recurrent pain symptoms in young schoolchildren are often multiple. Pain. 2006, 121: 145-150. 10.1016/j.pain.2005.12.017.CrossRefPubMed
45.
Smedbraten BK, Natvig B, Rutle O, Bruusgaard D: Self-reported bodily pain in schoolchildren. Scand J Rheumatol. 1998, 27: 273-276.PubMed
46.
Hoftun GB, Romundstad PR, Rygg M: Factors associated with adolescent chronic non-specific pain, chronic multisite pain, and chronic pain with high disability: the Young-HUNT Study 2008. J Pain. 2012, 13: 874-883. 10.1016/j.jpain.2012.06.001.CrossRefPubMed
47.
Wiesenfeld-Hallin Z: Sex differences in pain perception. Gend Med. 2005, 2: 137-145. 10.1016/S1550-8579(05)80042-7.CrossRefPubMed
48.
Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choiniere M: A systematic literature review of 10 years of research on sex/gender and pain perception - part 2: do biopsychosocial factors alter pain sensitivity differently in women and men?. Pain. 2012, 153: 619-635. 10.1016/j.pain.2011.11.026.CrossRefPubMed
49.
Mogil JS, Bailey AL: Sex and gender differences in pain and analgesia. Prog Brain Res. 2010, 186: 141-157.PubMed
50.
Smitherman TA, Ward TN: Psychosocial factors of relevance to sex and gender studies in headache. Headache. 2011, 51: 923-931. 10.1111/j.1526-4610.2011.01919.x.CrossRefPubMed
51.
Unruh AM: Gender variations in clinical pain experience. Pain. 1996, 65: 123-167. 10.1016/0304-3959(95)00214-6.CrossRefPubMed
52.
Dorner TE, Muckenhuber J, Stronegger WJ, Rasky E, Gustorff B, Freidl W: The impact of socio-economic status on pain and the perception of disability due to pain. Eur J Pain. 2011, 15: 103-109. 10.1016/j.ejpain.2010.05.013.CrossRefPubMed
Metadata
Title
Chronic pain and pain-related disability across psychiatric disorders in a clinical adolescent sample
Authors
Wenche L Mangerud
Ottar Bjerkeset
Stian Lydersen
Marit S Indredavik
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2013
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-13-272

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