The Social Toll of Teen Pain and Mental Health Struggles

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Adolescents with both chronic pain and mental health symptoms experience more significant challenges in physical, social and family functioning compared with those with only one type of symptom or none at all. Adolescents with co-occurring symptoms have notably worse social functioning than those with pain-only or no symptoms, while family functioning is more affected in adolescents with mental health-only symptoms.

According to recent estimations, approximately 10-20% of adolescents are diagnosed with mental health disorders globally, with depression and anxiety cited as the most prevalent conditions. In the United Kingdom, 18% of people aged seven to 16 and 22% aged 17 to 24 reported a mental health disorder, although this may be an underestimation as some children may not seek mental health support.

Additionally, chronic pain is linked to increased mental health problems. A recent study has shown 44.2% of adolescents experience chronic pain on a weekly basis over the past 6 months and pain is associated with higher levels of depression, anxiety and behavioral disorders.

“Many adolescents who experience chronic pain and increased levels of mental health symptoms also report impaired physical, social, and emotional functioning,” wrote a group of investigators led by Sharon Bateman, PhD, a researcher in the Department of Psychology at the University of Bath. “For example, higher levels of self-reported depressive and anxiety symptoms in adolescents who experience chronic migraine are associated with poorer physical, social and emotional functioning than adolescents with episodic migraine or no pain. However, the relationship between chronic pain, functioning and mental health symptoms in adolescents is often complex and poorly understood.”

An online cross-sectional study quantitative study compared the challenges to psychosocial function across adolescents with co-occurring chronic pain and mental health symptoms; adolescents with only chronic pain; adolescents with only mental health symptoms; and adolescents who did not report either symptom. Self-reported questionnaires evaluated their pain experiences, mental health symptoms and psychosocial functioning.

A total of 137 adolescents aged between 11 and 19 years participated in the survey. Most were female (83.2%) and most were White (95.6%). The most frequently reported locations of pain included lower limb, back, neck, multisite pain and headache/migraine. The most common mental health symptoms were depression, anxiety, panic attacks, low mood and self-harm.

Results showed significant differences in physical, social and family functioning across groups after controlling for pain intensity. Participants with concomitant pain and mental health symptoms and those with pain-only symptoms demonstrated significantly worse physical functioning when compared with those with mental health-only symptoms or those with neither. Social functioning was also significantly worse for adolescents who had both chronic pain and mental health symptoms compared with those with pain-only symptoms or no symptoms. Family functioning was significantly worse among those with mental health-only symptoms compared with adolescents with either pain-only symptoms or no symptoms.

Findings suggest that co-occurring pain and mental health issues mainly impact social functioning, emphasizing the need for standardized assessment and treatment plans to better address these complex symptoms in adolescents.

Investigators noted the study was strengthened by recruiting patients with a wide range of mental health symptoms in comparison to other studies. However, they said using self-report methods to determine mental health symptoms and functioning led to a lack of corroboration in participants’ assessments of their symptoms. Additionally, the sample was predominantly White and female, which limited the generalization of the results.

“Assessment measures should aim to assess a wider variety of mental health disorders and span diverse functioning domains to allow for a thorough understanding of co-occurring symptoms presented by young people in order to appropriately inform individualized, interdisciplinary treatment plans,” investigators concluded.