Alessandro Andreucci1, Paul Campbell1, Kate M Dunn1
1) United Kingdom
Musculoskeletal pain is a major burden on society. Adults with psychological morbidity are at higher risk for musculoskeletal pain onset, but little is known about this relationship in adolescents. We tested whether adolescents with psychological and behavioural problems (internalizing symptoms: emotional symptoms, peer problems; externalizing symptoms: conduct problems, hyperactivity) were at increased risk of developing musculoskeletal pain.
Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed (adolescents aged 13 at baseline, 17 at follow-up; N = 1,515). ALSPAC is a longitudinal population-based study investigating the contribution of both genetic and environmental factors on the health of both parents and children. Internalizing and externalizing symptoms were reported by parents at baseline using the Strength and Difficulties Questionnaire. Outcome was self-reported musculoskeletal pain onset using a pain questionnaire assessed 4 years later. Associations were investigated using logistic regression presenting odds ratios (OR) and 95% Confidence Intervals (CI) adjusted for potential confounders (smoking, marijuana use, drug use and physical activity).
At follow-up, 39% of adolescents (n = 587) developed musculoskeletal pain. Adolescents with internalizing symptoms were not significantly more likely to develop musculoskeletal pain (unadjusted OR 1.3; 95% CI 0.92, 1.96; adjusted OR 1.2; 0.79, 1.88). However adolescents with externalizing symptoms were significantly more likely to develop musculoskeletal pain (unadjusted OR 2.0; 1.31, 3.09), though this result was not significant after adjustment (adjusted OR 1.6; 0.95, 2.63).
Analysis shows that adolescents with externalizing symptoms (e.g. conduct problems, hyperactivity) are at increased risk of developing musculoskeletal pain 4 years later. Adjustment did show some attenuation of this effect, but this may be due to the non-random nature of exclusions from missing data. Future research is required to understand the reasons for this association.
