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J Pain. 2018 Jan;19(1):99-110. doi: 10.1016/j.jpain.2017.08.011. Epub 2017 Oct 12.

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

Author information

1
Department of Social Medicine, Federal University of Espírito Santo, Vitória, Brazil; Post Graduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil. Electronic address: mcviana@uol.com.br.
2
Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.
3
Post Graduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil.
4
University of California, Davis, Center for Reducing Health Disparities, School of Medicine, Sacramento, California.
5
Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
6
Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium.
7
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
8
Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisbon, Portugal.
9
Psychology Research Institute, University of Ulster, Londonderry, United Kingdom.
10
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
11
College of Medicine, Al-Qadisiya University, Diwania Governorate, Iraq.
12
Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico.
13
National School of Public Health, Management and Professional Development, Bucharest, Romania.
14
IRCCS St. John of God Clinical Research Centre/IRCCS, Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
15
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain.
16
Shenzhen Insitute of Mental Health & Shenzhen Kanging Hospital, Shenzen, China.
17
Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France.
18
Ministry of Health Israel, Mental Health Services, Israel.
19
National Institute of Health, Peru.
20
Colegio Mayor de Cundinamarca University, Bogota, Colombia.
21
Centre of Monitoring and Analyses of Population Health Status, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.
22
Department of Health Care Policy, Harvard Medical School, Boston, Massachusettes.

Erratum in

Abstract

Associations between depression/anxiety and pain are well established, but its directionality is not clear. We examined the associations between temporally previous mental disorders and subsequent self-reported chronic back/neck pain onset, and investigated the variation in the strength of associations according to timing of events during the life course, and according to gender. Data were from population-based household surveys conducted in 19 countries (N = 52,095). Lifetime prevalence and age of onset of 16 mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 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 of 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:

Previous mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition 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 with later-onset disorders.

KEYWORDS:

Back or neck pain; cross-national studies; mental health; mental-physical comorbidity; psychiatric epidemiology

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