Journal Article

Estimating the longitudinal association between pain characteristics and clinical outcomes in young people with mental ill-health

Filia, Kate, Watson, Amity E., Herrman, Helen, Cotton, Susan M., Tagliaferri, Scott D., Hetrick, Sarah E., Schmaal, Lianne, Gao, Caroline X., Parker, Alex G., Menssink, Jana, Hickie, Ian B., Nguyen, Josh, Oosterwijk, Valerie A., McGorry, Patrick D., Rickwood, Debra

2025

Overview

Mental ill-health has a major impact on young people, with pain often co-occurring. We estimated the prevalence and impact of pain in young people with mental ill-health. Longitudinal data (baseline and three-month follow-up) of 1,107 Australian young people (aged 12-25 years) attending one of five youth mental health services. Multi-level linear mixed models estimated associations between pain characteristics (frequency, intensity, and limitations) and outcomes with false discovery rate (FDR) adjustment. Pain characteristics were baseline-centered to estimate if the baseline score ( ) and/or change from baseline ( was associated with outcomes. At baseline, 16% reported serious pain more than 3 days, 51% reported at least moderate pain, and 25% reported pain-related activity limitations in the last week. Between participants, higher serious pain frequency was associated with greater anxiety symptoms ( [95%CI]: 0.90 [0.45, 1.35], FDR-p=0.001), higher pain intensity was associated with greater symptoms of depression (1.50 [0.71, 2.28], FDR-p=0.001), anxiety (1.22 [0.56, 1.89], FDR-p=0.002), and suicidal ideation (3.47 [0.98, 5.96], FDR-p=0.020), and higher pain limitations were associated with greater depressive symptoms (1.13 [0.63, 1.63], FDR-p<0.001). Within participants, increases in pain intensity were associated with increases in tobacco use risk (1.09 [0.48, 1.70], FDR-p=0.002), and increases in pain limitations were associated with increases in depressive symptoms (0.99 [0.54, 1.43], FDR-p<0.001) and decreases in social and occupational functioning (-1.08 [-1.78, -0.38], FDR-p=0.009). One-in-two young people seeking support for mental ill-health report pain. Youth mental health services should consider integrating pain management.

• Publisher: Cambridge University Press
• Subject: Adolescent / Adult / Anxiety / Anxiety - epidemiology / Australia - epidemiology / Child / Chronic pain / Clinical outcomes / Comorbidity / Depression - epidemiology / Drug use / Female / Humans / Limitations / Longitudinal Studies / Male / Mental depression / Mental disorders / Mental Disorders - epidemiology / Mental health / Mental health care / Mental health services / Original / Original Article / Pain / Pain - epidemiology / Pain - psychology / Prevalence / Quality of life / Questionnaires / Suicidal behavior / Suicidal ideation / Suicide / Symptoms / Tobacco / Treatment outcomes / Young Adult / Young adults / Youth