Back and neck pain are related to mental health problems in adolescence

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Abstract

Background

There is a high prevalence of mental health problems amongst adolescents. In addition there is a high prevalence of spinal pain in this population. Evidence suggests that these conditions are related. This study sought to extend earlier findings by examining the relationship between mental health problems as measured by the Child Behaviour Check List (CBCL) and the experience of back and neck pain in adolescents.

Methods

One thousand five hundred and eighty participants (mean age 14.1 years) from the Western Australian Pregnancy (Raine) Study provided cross-sectional spinal pain and CBCL data.

Results

As predicted, there was a high prevalence of back and neck pain in this cohort. On the whole, females reported more mental health difficulties than males. There were strong relationships between the majority of symptom scales of the CBCL and back and neck pain. Scores on the CBCL were associated with higher odds of comorbid back and neck pain.

Conclusions

These findings strongly support the need to consider both psychological and pain symptoms when providing assessments and treatment for adolescents. Further research is required to inform causal models.

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Most cited references 42

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A review of psychological risk factors in back and neck pain.

S J Linton (2000)

The literature on psychological factors in neck and back pain was systematically searched and reviewed. To summarize current knowledge concerning the role of psychological variables in the etiology and development of neck and back pain. Recent conceptions of spinal pain, especially chronic back pain, have highlighted the role of psychological factors. Numerous studies subsequently have examined the effects of various psychological factors in neck and back pain. There is a need to review this material to ascertain what conclusions may be drawn. Medical and psychological databases and cross-referencing were used to locate 913 potentially relevant articles. A table of 37 studies was constructed, consisting only of studies with prospective designs to ensure quality. Each study was reviewed for the population studied, the psychological predictor variables, and the outcome. The available literature indicated a clear link between psychological variables and neck and back pain. The prospective studies indicated that psychological variables were related to the onset of pain, and to acute, subacute, and chronic pain. Stress, distress, or anxiety as well as mood and emotions, cognitive functioning, and pain behavior all were found to be significant factors. Personality factors produced mixed results. Although the level of evidence was low, abuse also was found to be a potentially significant factor. Psychological factors play a significant role not only in chronic pain, but also in the etiology of acute pain, particularly in the transition to chronic problems. Specific types of psychological variables emerge and may be important in distinct developmental time frames, also implying that assessment and intervention need to reflect these variables. Still, psychological factors account for only a portion of the variance, thereby highlighting the multidimensional view. Because the methodologic quality of the studies varied considerably, future research should focus on improving quality and addressing new questions such as the mechanism, the developmental time factor, and the relevance that these risk factors have for intervention.

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Stress, sensitive periods and maturational events in adolescent depression.

Susan L. Andersen, Martin Teicher (2008)

In this paper, we provide an overview of how the maturation of specific brain regions and stress exposure during windows of vulnerability initiate a series of events that render adolescents exceptionally susceptible to the development of depression. This stress-incubation/corticolimbic development cascade provides a means of understanding why depression emerges with such force and frequency in adolescence. The development of the prefrontal cortex, hippocampus, amygdala and ventral striatum is described from a translational perspective as they relate to stress exposure, onset, pathogenesis and gender differences in depression. Adolescent depression is a serious recurrent brain-based disorder. Understanding the genesis and neurobiological basis is important in the development of more effective intervention strategies to treat or prevent the disorder.

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The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins.

Kirsten Ohm Kyvik, Charlotte Leboeuf-Yde, Lise Hestbaek … (2006)

Prospective study with 8-year follow-up. To describe the evolution of low back pain from adolescence into adulthood. High prevalence rates of low back pain among children and adolescents have been demonstrated in several studies, and it has been theorized that low back pain in childhood may have important consequences for future low back pain. It is important to understand the nature of such a link if effective preventive programs are to be established. Almost 10,000 Danish twins born between 1972 and 1982 were surveyed by means of postal questionnaires in 1994 and again in 2002. The questionnaires dealt with various aspects of general health, including the prevalence of low back pain, classified according to number of days affected (0, 1-7, 8-30, >30). Low back pain in adolescence was found to be a significant risk factor for low back pain in adulthood with odds ratios as high as four. We also demonstrated a dose-response association: the more days with low back pain at baseline, the higher the risk of future low back pain. Twenty-six percent of those with low back pain for more than 30 days during the baseline year also had more than 30 days with low back pain during the follow-up year. This was true for only 9% of the rest of the sample. Our study clearly demonstrates correlations between low back pain in childhood/adolescence and low back pain in adulthood. This should lead to a change in focus from the adult to the young population in relation to research, prevention, and treatment.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central

ISSN (Electronic): 1471-2458

Publication date Collection: 2011

Publication date (Electronic): 25 May 2011

Volume: 11

Page: 382

Affiliations

[1 ]School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA 6845, Australia

[2 ]School of Physiotherapy, Curtin University, GPO Box U1987, Perth, WA 6845, Australia

[3 ]School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, WA 6845, Australia

[4 ]Telethon Institute for Child Health Research, Roberts Road, Perth, WA 6008, Australia

[5 ]Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, Australia

Article

Publisher ID: 1471-2458-11-382

DOI: 10.1186/1471-2458-11-382

PMC ID: 3123209

PubMed ID: 21609488

SO-VID: 122ebd1a-913e-4212-9fba-c0dd0ff8a8cf

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Back and neck pain are related to mental health problems in adolescence

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Abstract

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Emerald: Healthier Lives

Most cited references 42

A review of psychological risk factors in back and neck pain.

Stress, sensitive periods and maturational events in adolescent depression.

The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins.

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