Stanisic Nikola, Sharma Sonia, Vallin Simon, Nilsson Peter M, Östergren Per-Olof, Lövgren Anna, List Thomas, Häggman-Henrikson Birgitta
Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
Faculty of Odontology, Malmö University, Malmö, Sweden.
Eur J Pain. 2025 Oct;29(9):e70110. doi: 10.1002/ejp.70110.
The multifactorial nature of chronic pain should be reflected in pain assessment. The aim of this observational study comparing samples from three generations assessed at different times was to present differences in pain, stress and mental well-being.
Pain sites, widespread pain, stress (Perceived Stress Scale-4) and mental well-being (30-item General Health Questionnaire) were described across generations from the Malmö neck and shoulder study (parents, Generation 1, n = 12,607), Malmö offspring study, and Malmö Offspring pain study (children and grandchildren, Generation 2, n = 1572; Generation 3, n = 936).
Pain prevalence remained comparable across generations. In all generations, women reported more pain sites compared to men, mean difference 1.0 (95% CI 0.9-1.1) in Generation 1, mean difference 1.3 (95% CI 1.0-1.6) in Generation 2, and mean difference 0.9 (95% CI 0.5-1.3) in Generation 3. The frequency of widespread pain for women and men was 28% and 16% in Generation 1, 27% and 12% in Generation 2, and 22% and 15% in Generation 3, respectively. Perceived stress levels were consistently higher in Generation 2 and 3 compared to Generation 1 for both women and men. Among women, mental well-being remained stable between Generation 1 and 2 but declined significantly in Generation 3 (mean difference 3.2, 95% CI 2.4-4.3).
The results suggest significant gender disparities, with women consistently reporting more pain sites, higher stress levels, and reduced mental well-being compared to men. Furthermore, the findings suggest that generational differences in coping-or other factors-may mitigate the impact of psychosocial distress on pain prevalence, warranting further research.
This study highlights the comparability of pain prevalence across generations despite increasing stress and declining mental well-being, particularly in women. These findings emphasise the importance of integrating mental health support and gender-specific coping strategies into pain management, offering insights into biopsychosocial mechanisms underlying the interactions between pain and perceived stress.
慢性疼痛的多因素性质应在疼痛评估中得到体现。这项观察性研究比较了在不同时间评估的三代样本，目的是呈现疼痛、压力和心理健康方面的差异。
从马尔默颈部和肩部研究（父母，第一代，n = 12607）、马尔默后代研究以及马尔默后代疼痛研究（子女和孙辈，第二代，n = 1572；第三代，n = 936）中描述了各代人的疼痛部位、广泛性疼痛、压力（感知压力量表-4）和心理健康（30项一般健康问卷）情况。
各代人的疼痛患病率保持相当。在所有代中，女性报告的疼痛部位比男性更多，第一代的平均差异为1.0（95%置信区间0.9 - 1.1），第二代的平均差异为1.3（95%置信区间1.0 - 1.6），第三代的平均差异为0.9（95%置信区间0.5 - 1.3）。第一代中女性和男性的广泛性疼痛频率分别为28%和16%，第二代分别为27%和12%，第三代分别为22%和15%。第二代和第三代中男性和女性的感知压力水平始终高于第一代。在女性中，第一代和第二代之间心理健康保持稳定，但在第三代中显著下降（平均差异3.2，95%置信区间2.4 - 4.3）。
结果表明存在显著的性别差异，女性始终报告比男性更多的疼痛部位、更高的压力水平和更低的心理健康状况。此外，研究结果表明应对方式或其他因素的代际差异可能减轻社会心理困扰对疼痛患病率的影响，值得进一步研究。
本研究强调了尽管压力增加和心理健康下降，但各代人疼痛患病率的可比性，尤其是在女性中。这些发现强调了将心理健康支持和针对性别的应对策略纳入疼痛管理的重要性，为疼痛与感知压力之间相互作用的生物心理社会机制提供了见解。
