Exploring the association between the presence and characteristics of pain and lifetime depression in adolescents: A cross sectional ABCD study analysis

IntroductionDepression and pain co occur, even during adolescence. However, there is limited knowledge on the association between pain and lifetime depression in community samples, and which biopsychosocial factors are associated with this co occurrence. MethodsCross sectional analysis of the Adolescent Brain and Cognitive Development (ABCD) two year follow up. We explored associations between the presence and characteristics of pain (intensity, duration, activity limitations, and number of pain sites) and lifetime depression using logistic regression. We explored associations of brain structure, physical, behavioural, emotional, social, and cognitive factors with lifetime depression and pain compared to having had one or neither condition using multinomial logistic regression. ResultsA total of 5,211 adolescents (mean age=12.0 years) who had: (1) no lifetime mental ill health and no pain (n=3,327); (2) pain only (n=1,407); (3) lifetime depressive disorder but no pain (n=272); and (4) lifetime depressive disorder and pain (n=205) were included. Pain presence was associated with lifetime depression (OR[95%CI]: 1.76 [1.45, 2.13], p<0.001). Pain-related activity limitations (1.13 [1.06, 1.21], p<0.001) and the number of pain sites (1.06 [1.02, 1.09], p<0.001) were associated with lifetime depression. Various behavioural, emotional, social, and cognitive, but not brain structure or physical factors, were associated with lifetime depression and pain. LimitationsFuture longitudinal analyses should validate the benefit of prognostic markers on predicting co occurring depression and pain. ConclusionsThese results support an association between the presence and characteristics of pain and lifetime depression during adolescence, and the need for more integrated clinical care of youth experiencing both depression and pain.