Journal of Pain
Journal of Pain
5 years ago

Prior Mental Disorders and Subsequent Onset of Chronic Back or Neck Pain: Findings From 19 Countries.

Associations between depression/anxiety and pain are well established, but its directionality is not clear. We examined the associations between temporally prior mental disorders and subsequent self-reported chronic back/neck pain onset, and investigated the variation in the strength of associations by timing of events during the life course, and by gender. Data were from population-based household surveys conducted in 19 countries (n=52,095). Lifetime prevalence and age-of-onset of 16 DSM-IV mental disorders, and the occurrence and age-of-onset of back/neck pain were assessed using the Composite International Diagnostic Interview. Survival analyses estimated the associations between first onset of mental disorders and subsequent back/neck pain onset. All mental disorders were positively associated with back/neck pain in bivariate analyses; most (12/16) remained so after adjusting for psychiatric comorbidity, with a clear dose-response relationship between number of mental disorders and subsequent pain. Early-onset disorders were stronger predictors of pain; when adjusting for psychiatric comorbidity, this remained the case for depression/dysthymia. No gender differences were observed. In conclusion, individuals with mental disorder, beyond depression and anxiety, are at higher risk of developing subsequent back/neck pain, stressing the importance of early detection of mental disorders, and highlight the need of assessing back/neck pain in mental health clinical settings. Perspective Prior DSM-IV mental disorders are positively associated with subsequent back/neck pain onset, with a clear dose-response relationship between number of mental disorders and subsequent pain. Earlier-onset mental disorders are stronger predictors of subsequent pain onset, compared to lateronset disorders.

Publisher URL: www.sciencedirect.com/science

DOI: S1526590017307320

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