Social science & medicine (1982) · 2025
Syndemic interactions of chronic pain, mental health problems, and opioid misuse and their association with academic performance and quality of life among college students.
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Qeadan Fares, Thornquist Rose, Tingey Benjamin
Аннотация
BACKGROUND: College students experience multiple stressors impacting academic performance and quality of life (QoL), including chronic pain, mental health issues, and opioid misuse, which can co-occur and exacerbate one another. Guided by syndemic theory, this study examined the associations between these three health conditions and academic performance and QoL.
METHODS: We analyzed cross-sectional data from 334,957 students from the ACHA-NCHA III survey (2019-2022). Lifetime chronic pain and mental health problems were self-reported based on provider diagnosis or symptoms. Opioid misuse was defined as ever using heroin or using prescription opioids for nonmedical purposes. Syndemic burden was measured using individual indicators, a composite count (0-3), and interactions terms. Academic performance was measured via a binary indicator of impeded performance, and QoL was assessed using a weighted average score from four validated WHOQOL-BREF domains. Multiple logistic and linear regression were used, adjusting for demographic and contextual variables.
RESULTS: Greater syndemic burden was associated with worse outcomes. Students with all three conditions had the highest odds of impeded academic performance (aOR = 7.38, 95 % CI: 6.52, 8.35) and the lowest QoL scores (βˆADJ = -12.05, 95 % CI: -12.37, -11.73). Each factor was independently associated with adverse outcomes, and significant interaction effects, especially when mental health problems were present, suggested syndemic amplification.
CONCLUSION: These findings support a syndemic framework linking chronic pain, mental health problems, and opioid misuse with academic and QoL outcomes in college students. Interventions should prioritize integrated mental health services and non-pharmacological pain management options in college health systems.
METHODS: We analyzed cross-sectional data from 334,957 students from the ACHA-NCHA III survey (2019-2022). Lifetime chronic pain and mental health problems were self-reported based on provider diagnosis or symptoms. Opioid misuse was defined as ever using heroin or using prescription opioids for nonmedical purposes. Syndemic burden was measured using individual indicators, a composite count (0-3), and interactions terms. Academic performance was measured via a binary indicator of impeded performance, and QoL was assessed using a weighted average score from four validated WHOQOL-BREF domains. Multiple logistic and linear regression were used, adjusting for demographic and contextual variables.
RESULTS: Greater syndemic burden was associated with worse outcomes. Students with all three conditions had the highest odds of impeded academic performance (aOR = 7.38, 95 % CI: 6.52, 8.35) and the lowest QoL scores (βˆADJ = -12.05, 95 % CI: -12.37, -11.73). Each factor was independently associated with adverse outcomes, and significant interaction effects, especially when mental health problems were present, suggested syndemic amplification.
CONCLUSION: These findings support a syndemic framework linking chronic pain, mental health problems, and opioid misuse with academic and QoL outcomes in college students. Interventions should prioritize integrated mental health services and non-pharmacological pain management options in college health systems.