Associations between mental health and cervical, thoracic, and lumbar back pain in adolescents: A cross-sectional study.

BACKGROUND

Low back pain is a significant emergent health disorder in adolescence. It is predicted that around 843 million subjects worldwide will present this condition in 2050. We investigated whether symptoms of anxiety, depression, and suicidal behavior are associated with back pain in adolescents.

METHODS

This is a cross-sectional school-based study including 4514 student participants aged 14-19 years. Data were collected using the WHO's "Global School-Based Student Health Survey". Anxiety symptoms were assessed with the Social Anxiety Scale for Adolescents. The Depression Scale of the Center for Epidemiologic Studies was used to estimate depressive symptomatology. Suicidal behaviors were assessed with two questions about thoughts and plans for suicide. The presence (yes, no) of each of cervical, thoracic, and lumbar back pain were assessed with the use of a drawing of the human body with spine areas delimited. Multivariable logistic regression analyses were used to study the presence of three outcomes of back pain (cervical, thoracic, and lumbar) and associated factors.

RESULTS

Adolescents with cervical pain were more likely to report social anxiety (OR = 1.0, CI: 1.00-1.02). Depression symptomatology was associated with pain in the tree segments of the spine: cervical (OR = 1.01, CI: 1.00-1.02), thoracic (OR = 1.02, CI: 1.01-1.02), and lumbar (OR = 1.02, CI: 1.01-1.02). No association was observed between suicidal behavior and cervical (OR = 0.86 CI: 0.743-1.017), thoracic (OR = 0.92, CI: 0.79-1.08), and lumbar back pain (OR = 0.86, CI: 0.73-1.01).

LIMITATIONS: It is not possible to affirm causality in the interpretation of findings.

CONCLUSIONS

Social anxiety and depression symptomatology were associated with back pain in adolescents.