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Abstract
Objectives To examine the association between multisite musculoskeletal pain in adolescence and mental health disorders in young adulthood.
Design and setting Data were obtained from a linkage between the Norwegian Patient Registry (2008–2012) and the Norwegian Arctic Adolescent Health Study, a school-based survey conducted among 10th grade students in North Norway (2003–2005).
Participants In total, 3987 (68%) of all 5877 invited participants consented to the registry linkage.
Outcome measures Mental healthcare use and disorders from age 18–20 to 23–25 years (5 years).
Methods Musculoskeletal pain was measured by the number of musculoskeletal pain sites. Multivariable logistic regression was used to explore the association with later mental healthcare use and disorders.
Results Multisite adolescent musculoskeletal pain was significantly associated with an increase in mental healthcare use and mental health disorders in young adulthood. The relationship was stronger for anxiety and mood disorders, in both genders. Overall, the association between musculoskeletal pain and later mental health problems was attenuated after controlling for adolescent psychosocial and mental health problems, not by physical or sedentary activity. This could be due to confounding or mediation. However, when examining different mental health disorders, we found musculoskeletal pain to be significantly associated with anxiety disorders, and showing a strong trend in mood disorders, when adjusted for the adolescent factors.
Conclusions Physicians should be aware that multisite adolescent pain is associated with mental health problems in adolescence, and that these adolescents are at increased risk of mental health disorders in young adulthood. As youth troubled by mental health problems commonly present physical symptoms it is important to examine for psychosocial problems in order to offer early interventions.
- PSYCHIATRY
- MENTAL HEALTH
- PUBLIC HEALTH
- EPIDEMIOLOGY
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Contributors CE has contributed to the concept and design of the study, the acquisition of registry data, analysis and interpretation of data, drafting and revising the manuscript. BS has contributed in the analysis and interpretation of data, critical review and revision of the manuscript. SK has contributed in the concept and design of the study, acquisition of data, analysis and interpretation of data, critical review and revision of the manuscript.
Funding UiT–The Arctic University of Norway, The Centre for Sami Health Research and the Norwegian Institute of Public Health for funding of the Norwegian Arctic Adolescent Health Study, The University Hospital of North Norway and Nordland Hospital for funding the registry linkage. Data from the Norwegian Patient Register (NPR) has been used in this publication. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the NPR is intended nor should be inferred.
Competing interests None declared.
Ethics approval The students and their parents were given written information about the study, and the students provided written consent. The Norwegian Data Inspectorate and the school authorities approved the NAAHS. The Regional Medical Ethical Committee approved the NAAHS and the registry linkage. The Norwegian Institute of Public Health and Statistics Norway carried out the linkage.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.