Severity of Chronic Pain in German Adolescent School Students

Abstract

Objectives: Prevalence estimates of severe chronic pain in pediatric community samples are rare and inconclusive. This study aimed to (1) examine the prevalence of chronic pain severity grades in school children and (2) investigate differences between pain severity grades for pain-related characteristics, including pain locations, sociodemographic characteristics, emotional functioning, insomnia, school factors, and health care utilization. Materials and Methods: This cross-sectional observational study was conducted with 2220 school students in Germany (52% female individuals, age: M=13.0; SD=1.8; range, 10 to 18 y). Pain severity was assessed using the validated Chronic Pain Grades for adolescents. Comparisons between Chronic Pain Grade subgroups of adolescent characteristics were conducted using χ2 tests, Kruskal-Wallis tests, and 1-way analysis of variance. Results: In school students, 31.0% had chronic pain with 8.2% categorized as severe. Individuals with higher pain severity tended to be girls and have multisite pain, more symptoms of depression and generalized anxiety, and a higher emotional burden of pain. Individuals with higher pain severity also reported less school satisfaction, lower perceived school performance, and more insomnia. Pain medication intake and physician visits because of pain were more common in those with more severe pain. Discussion: Severe chronic pain affects nearly 1 in 10 adolescent school students and is associated with several negative health outcomes and increased health care utilization. It is important to ensure that specialized pain treatment programs are available to these students and that they are aware of the different negative health outcomes associated with the pain condition.

Economic long‐term effects of intensive interdisciplinary pain treatment in paediatric patients with severe chronic pain: Analysis of claims data

“…Between 30% and 44% of adolescent school children experience chronic pain (Gobina et al, 2019;Wager et al, 2020). Around 8% of children and adolescents report disabling chronic pain and are likely in need of specialized pain treatment (Könning et al, 2021). However, before entering specialized care, those patients often utilize a multitude of healthcare services without lasting improvement.…”

Individual Differences in Concurrent Developmental Trajectories of Pain and Insomnia in Adolescents Are Predicted by Chronotype and Arousal-causing Pre-sleep Behaviors.

“…First, for current purposes, we summarized the experience of three common types of pain (musculoskeletal pain, headache and abdominal pain) in an average pain grade, taking into account the intensity, frequency, and interference of the experience. Although this composite measure captures covariance across different pain types with insomnia 5 , future studies might want to focus on co-developmental patterns in speci c pain types, which would also allow interpretation of the pain grades in terms of pain-related disability only 17,59 . Indeed, the co-development of pain and insomnia might turn out to be different for speci c pain types 60 .…”

“…Pain grades. A composite "pain grade" was constructed based on the above-mentioned facets of the pain experience (pain intensity, pain frequency, and pain interference) 17,27 , as described in Table 1. We calculated separate pain grades for musculoskeletal pain, abdominal pain, and headache.…”

“…A personoriented perspective also allows for an exploration of factors that explain and predict different codeveloping patterns of pain and insomnia. Relatively little is known of such predictors or risk factors, but potential candidates include female gender, older age, depression and anxiety, stress, low socioeconomic status (SES), and immigrant background 8, 14,17 . Moreover, since insomnia has been found to be a stronger predictor of future pain than vice versa, a focus on sleep-related risk factors has been proposed when examining comorbid pain and insomnia 8 .…”

Long‐term outcomes of children with severe chronic pain: Comparison of former patients with a community sample

“…Between 5% and 8% of children and adolescents experience severely disabling chronic pain resulting in high health care costs and serious limitations in functioning, everyday life and emotional well‐being (Groenewald et al., 2014; Huguet & Miró, 2008; Könning et al., 2021). Most of these chronic pain conditions are functional, i.e.…”