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.
This cross-sectional observational study was conducted with 2220 school students in Germany (52% female, age: M=13.0, SD=1.8, range 10-18▒y). Pain severity was assessed using the validated Chronic Pain Grades (CPG) for adolescents. Comparisons between CPG subgroups of adolescent characteristics were conducted using chi-squared tests, Kruskal-Wallis tests and one-way ANOVA.
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 due to pain were more common in those with more severe pain.
Severe chronic pain affects nearly one in ten school students, 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 adolescent students and that they are aware of the different negative health outcomes associated with the pain condition.