title: The relation between multiple pains and mental disorders: results from the World Mental Health Surveys.
abstract: It is unclear whether differences exist in the prevalence of mood, anxiety and alcohol use disorders among persons with multiple pain conditions compared with those with single pain problems. We conducted population surveys in 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific. Participants were community-dwelling adults (N=85,088). Mental disorders were assessed with the Composite International Diagnostic Interview. Pain was assessed by self-report. Both multiple and single site pain problems were associated with mood and anxiety disorders, but not with alcohol abuse or dependence. In general, the prevalence of specific mood and anxiety disorders followed a linear pattern with the lowest rates found among persons with no pain, intermediate rates among those with one pain, and highest rates among those with multi-site pain problems. Relative to persons not reporting pain, the pooled estimates of the age-sex adjusted odds ratios were 1.8 (1.7-2.0) for mood disorders and 1.9 (1.8-2.1) for anxiety disorders for persons with single site pain; 3.7 (3.3-4.1) for mood disorders and 3.6 (3.3-4.0) for anxiety disorders among those with multi-site pain. Our results indicate that the presence of multiple pain conditions was strongly and comparably associated with mood and anxiety disorders in diverse cultures. This consistent pattern of associations suggests that diffuse pain and psychiatric disorders are generally associated, rather than diffuse pain representing an idiom for expressing distress that is specific to particular cultural settings or diffuse pain solely representing a form of masked depression.
authors.affiliation: Department of Psychiatry, University of Ibadan, Ibadan, Nigeria. ogureje@comui.edu.ng
authors.forename: Oye
authors.initials: O
authors.lastname: Gureje
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
authors.forename: Lola
authors.initials: L
authors.lastname: Kola
authors.forename: Koen
authors.initials: K
authors.lastname: Demyttenaere
authors.forename: Yanling
authors.initials: Y
authors.lastname: He
authors.forename: José
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Lepine
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Angermeyer
authors.forename: Daphna
authors.initials: D
authors.lastname: Levinson
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Noboru
authors.initials: N
authors.lastname: Iwata
authors.forename: Aimee
authors.initials: A
authors.lastname: Karam
authors.forename: Guilherme Luiz
authors.initials: GL
authors.lastname: Guimaraes Borges
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.forename: Mark Oakley
authors.initials: MO
authors.lastname: Browne
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Bromet
authors.forename: Ron C
authors.initials: RC
authors.lastname: Kessler
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D014943:Global Health; D006306:Health Surveys; D006801:Humans; D038622:Internationality; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology*; D015995:Prevalence; D018434:Sickness Impact Profile