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Temporal Relationship Between Pain and Mental Health Conditions Among Children and Young People—A Population-Based Register Study in Sweden

Bondesson, Elisabeth LU orcid ; Bolmsjö, Beata Borgström LU ; Pardo, Fabian Larrosa and Jöud, Anna Saxne LU orcid (2024) In Journal of Pain 25(12).
Abstract

Both pain and mental health conditions are common among young people. They often co-occur, but we wanted to investigate further whether it is pain (abdominal pain, headache, musculoskeletal pain, menstrual pain) that precedes mental health conditions (depression, anxiety, stress, phobia) or whether it is the other way around, mental health conditions that precede pain. Using electronic health records—the Skåne Healthcare Register—we identified and followed young people aged 7 to 18 over a 13-year period and tracked all their registered diagnoses. Using Poisson regression, we analyzed the incidence rate ratio (IRR) of being diagnosed with mental health conditions after an initial diagnosis of pain and vice versa the IRR of being... (More)

Both pain and mental health conditions are common among young people. They often co-occur, but we wanted to investigate further whether it is pain (abdominal pain, headache, musculoskeletal pain, menstrual pain) that precedes mental health conditions (depression, anxiety, stress, phobia) or whether it is the other way around, mental health conditions that precede pain. Using electronic health records—the Skåne Healthcare Register—we identified and followed young people aged 7 to 18 over a 13-year period and tracked all their registered diagnoses. Using Poisson regression, we analyzed the incidence rate ratio (IRR) of being diagnosed with mental health conditions after an initial diagnosis of pain and vice versa the IRR of being diagnosed with pain after an initial diagnosis of a mental health condition. Among individuals with pain, 12,054 (23%) later received a diagnosis of a mental health condition. The IRR for a mental health condition after pain was 2.86 (95% (confidence interval) CI = 2.78–2.94) compared to not having pain, adjusted for age, sex, and prior health care consultations. Among individuals with mental health conditions, 3,688 (17%) later received a diagnosis of pain. The adjusted IRR was 1.57 (95% CI = 1.52–1.63). Compared to boys, girls had consistently higher estimates, and the same was found for the younger individuals compared to the older ones. Individuals with pain have a 3-fold increased risk of developing mental health conditions, while the risk of developing pain after mental health conditions was lower although still elevated compared to young people seeking care regardless of cause. Perspective: Young people with pain have a 3-fold increased risk of developing mental health conditions, while the reverse risk is lower but still elevated compared to young people without these conditions. Health care professionals must recognize the interplay between pain and mental health in young patients when diagnosing and planning treatment.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adolescents, children, electronic health record, mental health condition, pain
in
Journal of Pain
volume
25
issue
12
article number
104662
publisher
Elsevier
external identifiers
  • pmid:39209085
  • scopus:85204501535
ISSN
1526-5900
DOI
10.1016/j.jpain.2024.104662
language
English
LU publication?
yes
id
98d9fdae-4121-41a7-a41c-97746263e3c8
date added to LUP
2024-11-27 12:01:33
date last changed
2025-12-11 21:14:33
@article{98d9fdae-4121-41a7-a41c-97746263e3c8,
  abstract     = {{<p>Both pain and mental health conditions are common among young people. They often co-occur, but we wanted to investigate further whether it is pain (abdominal pain, headache, musculoskeletal pain, menstrual pain) that precedes mental health conditions (depression, anxiety, stress, phobia) or whether it is the other way around, mental health conditions that precede pain. Using electronic health records—the Skåne Healthcare Register—we identified and followed young people aged 7 to 18 over a 13-year period and tracked all their registered diagnoses. Using Poisson regression, we analyzed the incidence rate ratio (IRR) of being diagnosed with mental health conditions after an initial diagnosis of pain and vice versa the IRR of being diagnosed with pain after an initial diagnosis of a mental health condition. Among individuals with pain, 12,054 (23%) later received a diagnosis of a mental health condition. The IRR for a mental health condition after pain was 2.86 (95% (confidence interval) CI = 2.78–2.94) compared to not having pain, adjusted for age, sex, and prior health care consultations. Among individuals with mental health conditions, 3,688 (17%) later received a diagnosis of pain. The adjusted IRR was 1.57 (95% CI = 1.52–1.63). Compared to boys, girls had consistently higher estimates, and the same was found for the younger individuals compared to the older ones. Individuals with pain have a 3-fold increased risk of developing mental health conditions, while the risk of developing pain after mental health conditions was lower although still elevated compared to young people seeking care regardless of cause. Perspective: Young people with pain have a 3-fold increased risk of developing mental health conditions, while the reverse risk is lower but still elevated compared to young people without these conditions. Health care professionals must recognize the interplay between pain and mental health in young patients when diagnosing and planning treatment.</p>}},
  author       = {{Bondesson, Elisabeth and Bolmsjö, Beata Borgström and Pardo, Fabian Larrosa and Jöud, Anna Saxne}},
  issn         = {{1526-5900}},
  keywords     = {{Adolescents; children; electronic health record; mental health condition; pain}},
  language     = {{eng}},
  number       = {{12}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Pain}},
  title        = {{Temporal Relationship Between Pain and Mental Health Conditions Among Children and Young People—A Population-Based Register Study in Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.jpain.2024.104662}},
  doi          = {{10.1016/j.jpain.2024.104662}},
  volume       = {{25}},
  year         = {{2024}},
}