Open AccessThe association between chronic widespread pain and mental disorder: A population‐based study
Author(s) -
Benjamin Sidney,
Morris Stella,
McBeth John,
Macfarlane Gary J.,
Silman Alan J.
Publication year - 2000
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/1529-0131(200003)43:3<561::aid-anr12>3.0.co;2-o
Subject(s) - medicine , psychiatry , anxiety , population , somatization , odds ratio , prevalence of mental disorders , general health questionnaire , mental health , mood disorders , somatization disorder , environmental health
Objective Patients with chronic widespread pain (CWP) have been reported to have a greater prevalence of mental disorders and somatization than that found in the general population, but the true association between CWP and mental disorders is unknown. In this study, we investigated whether there is an increased prevalence of mental disorder in people with CWP from the general population. We also describe the psychiatric diagnoses associated with CWP. Methods In a population‐based case–control study, 1,953 subjects (75% of a random sample of individuals age 18–65 years) completed a questionnaire that included a pain assessment and the 12‐item General Health Questionnaire (GHQ‐12). Of 710 subjects scoring >1 on the GHQ‐12, 301 were assessed further using a structured psychiatric interview and detailed assessment of medical records to identify cases of mental disorder, in accordance with criteria of the 10th edition of the International Classification of Diseases. The association between CWP and mental disorder was modeled using logistic regression, adjusting for possible confounders including age, sex, and nonresponders. Results We estimated the overall population prevalence of mental illness to be 11.9%. The odds of having a mental disorder for subjects with versus those without CWP were 3.18 (95% confidence interval 1.97–5.11). Most subjects with mental disorders were diagnosed as having mood and anxiety disorders. Only 3 cases of somatoform disorders were identified, and all were associated with pain. Conclusion This study, although unable to demonstrate a cause‐and‐effect relationship, showed that 16.9% of those with CWP were estimated to have a psychiatric diagnosis, suggesting that these disorders should be identified and treated.