Highlights
- •Chronic pain and suicidal behavior are prevalent in adolescents.
- •A large prospective study examined pain-suicidality association in adolescents.
- •Chronic pain increased 50-70% risk of suicidal behavior 1 year later.
- •Pain assessment and treatment may be important for suicide prevention.
Abstract
Chronic pain and suicidal behavior are prevalent in adolescents. This longitudinal
study examined the associations between pain symptoms and suicidal behavior in adolescents.
A total of 7,072 adolescents participated in a follow-up study of behavior and health
in Shandong, China. A self-administered structured questionnaire was used to assess
pain symptoms (headache, stomachache, and other nonspecific pain), insomnia, anxiety/depression,
substance use, stressful life events, prior suicidal behavior, and family environment
in November-December in 2015. One year later, a follow-up survey was conducted. Mean
age of the sample was 14.6 years, and half were female. Of the sample, 44.8% and 8.4%
reported having one or more pain symptoms “sometimes” and “often”, respectively. A
total of 22.4% and 10.6% reported having lifetime suicidal behavior at baseline and
subsequent suicidal behavior over the 1-year follow-up, respectively. Frequent pain
was significantly associated with increased risk of suicidal behavior at baseline
(OR=1.64, 95%CI=1.32-2.03) and during the subsequent year (OR=1.50, 95%CI=1.17-1.93)
while adjusting for adolescent individual and family covariates. Among adolescents
without a history of prior suicidal behavior, frequent pain was significantly associated
with an approximately 70% increased risk of incident suicidal behavior (OR= 1.69,
95%CI=1.14-2.51). In conclusion, frequent pain appears to be predictive of adolescent
suicidal behavior one year later.
Perspective
This article presents the prospective associations of frequent pain symptoms with
suicidal behavior in adolescents. Frequent pain was associated with a 50-70% increased
risk of suicidal behavior 1 year later. The finding underscores the importance of
pain assessment and treatment in comprehensive suicide prevention efforts in adolescents.
Key Words
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Article info
Publication history
Published online: February 23, 2021
Accepted:
February 10,
2021
Received in revised form:
February 7,
2021
Received:
January 10,
2021
Footnotes
Funding: This work was funded in part for data collection by the National Natural Science Foundation of China (grant number 81573233).
Conflict of Interest: All authors have no conflict of interest to disclosure.
Ethical standards: The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
Identification
Copyright
© 2021 by United States Association for the Study of Pain, Inc.
