Persistent or recurrent pain is common among adolescents and is associated with poor functioning. The purpose of this study was to determine whether preteens who present with pain, and higher, co-occurring psychologic and somatic symptoms (PSS) are at higher risk for persistent pain than other children.
We conducted a secondary analysis of the longitudinal Adolescent Brain and Cognitive Development database (v 2.0.1) that includes 11,863 children aged 9-12 years. We differentiated children into baseline Pain/PSS profiles using the Child Behavior Checklist assessments of pain, cognitive-fogginess, somatic symptoms, depression, and anxiety and the Sleep Disorder Survey-Children somnolence subscale. We examined whether Pain/PSS Profile predicted one-year new/persistent pain when controlled for child characteristics and intergenerational mental health factors.
Four profiles were differentiated: No Pain/Low PSS, No Pain/High PSS, Pain/Low PSS, Pain/High PSS. Trauma exposure and family symptoms were associated with increased odds of being in the higher PSS groups. Baseline symptom profile predicted 14% of the variance in new/persistent pain at one-year. Compared to the No Pain/Low PSS group, an increased odds of one-year new or persistent pain was found in children with No Pain/High PSS (adj.OR 1.44 [95% CI 1.14, 1.82]), Pain/Low PSS (adj.OR 4.69 [4.01, 5.48]) and Pain/High PSS (adj.OR 5.48 [4.35, 6.91]).
Pre-teen children with higher comorbid Pain/PSS symptomology were at higher risk for new or persistent pain at one year when controlled for important child and family characteristics. Findings support the importance of considering co-occurring symptoms when evaluating children with pain.