The Co-occurrence of Pediatric Chronic Pain and Depression

Abstract

Objectives: Internalizing mental health issues co-occur with pediatric chronic pain at high rates and are linked to worse pain and functioning. Although the field has prioritized anxiety and posttraumatic stress disorder, little is known about co-occurring depression and chronic pain in youth, despite its high prevalence. The purpose of this narrative review was to examine the existing literature on the co-occurrence of pediatric chronic pain and depressive disorders and symptoms and propose a conceptual model of mutual maintenance to guide future research. Methods: The literature from both fields of pediatric pain and developmental psychology were searched to review the evidence for the co-occurrence of pediatric chronic pain and depression. Conceptual models of co-occurring mental health issues and chronic pain, as well as child depression, were reviewed. From both literatures, we provide evidence for a number of proposed child, parent, and neurobiological factors that may serve to mutually maintain both conditions over time. On the basis of this evidence, we propose a conceptual model of mutual maintenance and highlight several areas for future research in this area. Results: Evidence was found for the prevalence of depression in pediatric chronic pain as well as the co-occurrence of both conditions. The key mutually maintaining factors identified and proposed included neurobiological, intrapersonal (eg, cognitive biases, sleep disturbances, emotion regulation, and behavioral inactivation), and interpersonal (eg, parent mental health and pain, genes, and parenting) factors. Discussion: Given the dearth of research on mutual maintenance in this area, this review and conceptual model could drive future research in this area. We argue for the development of tailored treatments for this unique population of youth to improve outcomes.

<p>Young Minds: Mental Health and Transitional Care in Adolescent and Young Adult Rheumatology</p>

“…39 Current evidence supports the mainstay of management for such young people with a young person centered rehabilitation and pain management program involving psychology (often devised around a cognitive behavioral therapeutic model) as well as physiotherapy and occupational therapy. 40 For further discussion of this area, see Soltani et al 41…”

Exploring the relationship between pain and self-harm thoughts and behaviours in young people using network analysis

“…Headaches (8-83%) and abdominal pain (4-53%) are the most common pain complaints in young people, followed by musculoskeletal pain (4-40%) and back pain (12-24%), with also a considerable increase in prevalence rates in early adolescence (King et al, 2011;Martin, McGrath, Brown, & Katz, 2007). As the experience of pain comprises both the physical sensations and emotional response to it (Price, 2000;Soltani, Kopala-Sibley, & Noel, 2019), prolonged and severe pain may considerably affect an individual's mood (Noel, Groenewald, Beals-Erickson, Gebert, & Palermo, 2016;Soltani et al, 2019). A recent systematic review provides support for a relationship between pain and (non-)suicidal SHTBs in adolescence (Hinze et al, 2019).…”

Schmerzmedizinische Versorgung chronisch schmerzkranker Kinder und Jugendlicher in Deutschland

“…B. hinsichtlich des Schulbesuchs [26,29,33], des Schlafs [25,31], der sozialen Kontakte in der Peergroup oder des Ausübens vonHobbys [33,34]. Sie sind häufig mit anderen somatischen Beschwerden und in bis zu 60 % der Fälle mit psychischen Auffälligkeiten, insbesondere mit internalisierenden Störungen wie Angst, Depression oder posttraumatischer Belastungsstörung assoziiert [2,10,21,24,36,37,39].…”