Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden; Department of Research and Education, Skåne University Hospital, Lund, Sweden.
Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden; University Clinic Primary Care Skåne, Region Skåne, Sweden.
J Pain. 2024 Dec;25(12):104662. doi: 10.1016/j.jpain.2024.104662. Epub 2024 Aug 28.
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.
疼痛和心理健康状况在年轻人中都很常见。它们经常同时出现，但我们想进一步研究是疼痛（腹痛、头痛、肌肉骨骼疼痛、月经痛）先于心理健康状况（抑郁、焦虑、压力、恐惧症）出现，还是相反，心理健康状况先于疼痛出现。我们使用电子健康记录——斯科讷医疗登记处，确定并跟踪了 13 年间年龄在 7 至 18 岁的年轻人，并跟踪他们所有的登记诊断。我们使用泊松回归分析，分析了在初次诊断疼痛后被诊断为心理健康状况的发生率比（IRR），以及在初次诊断为心理健康状况后被诊断为疼痛的 IRR。在患有疼痛的个体中，有 12054 人（23%）后来被诊断为心理健康状况。与没有疼痛相比，疼痛后出现心理健康状况的 IRR 为 2.86（95%置信区间（CI）=2.78-2.94），调整了年龄、性别和先前的医疗咨询。在患有心理健康状况的个体中，有 3688 人（17%）后来被诊断为疼痛。调整后的 IRR 为 1.57（95% CI=1.52-1.63）。与男孩相比，女孩的估计值始终较高，与年龄较大的人相比，年龄较小的人也是如此。患有疼痛的个体出现心理健康状况的风险增加了 3 倍，而出现疼痛的风险虽然仍高于因其他原因寻求医疗的年轻人，但低于出现心理健康状况的风险。观点：患有疼痛的年轻人出现心理健康状况的风险增加了 3 倍，而相反的风险虽然较低，但仍高于没有这些状况的年轻人。医疗保健专业人员在诊断和规划治疗时，必须认识到年轻患者疼痛和心理健康之间的相互作用。
