title: Co-occurring chronic pain and obesity in children and adolescents: the impact on health-related quality of life.
abstract: OBJECTIVE
  Determine the impact of co-occurring chronic pain and obesity on health-related quality of life (HRQOL) in children and adolescents.
  
  
  METHODS
  Retrospective chart review of 319 children and adolescents (8 to 18 y) seen at a multispecialty chronic pain clinic. HRQOL was measured with the Pediatric Quality of Life Inventory (v.4.0). Total, physical and psychosocial summary scores, and subscale scores for emotional, social, and school functioning were compared for youth across weight groups (healthy weight, overweight, obese). Odds ratios (ORs) were calculated to assess the likelihood of impaired HRQOL with a combined impact of chronic pain and obesity compared with chronic pain alone. Using previously published data; we also assessed the likelihood of impaired HRQOL with a combined impact of chronic pain and obesity compared with obesity alone.
  
  
  RESULTS
  Across all domains of functioning, children and adolescents in the obese group reported lower HRQOL than the overweight and healthy weight groups. Emotional functioning was the exception; the obese group reported lower scores than the overweight group, but not the healthy weight group. The likelihood of impaired HRQOL was higher [OR, 2.2; 95% confidence interval (CI): 1.1-4.4] for children and adolescents with chronic pain and obesity than with chronic pain alone and higher than children and adolescents with obesity alone (OR, 3.7; 95% CI: 1.8-7.8).
  
  
  CONCLUSIONS
  Co-occurring chronic pain and obesity exacerbates the impact of chronic pain alone on the HRQOL of children and adolescents. Routinely screening pediatric patients with chronic pain for elevated body mass index is recommended.
authors.affiliation: Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, WI 53226, USA. khainsworth@chw.org
authors.forename: Keri R
authors.initials: KR
authors.lastname: Hainsworth
authors.forename: William Hobart
authors.initials: WH
authors.lastname: Davies
authors.forename: Kim A
authors.initials: KA
authors.lastname: Khan
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Weisman
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D002648:Child; D002908:Chronic Disease; D015897:Comorbidity; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000453:epidemiology*; D016017:Odds Ratio; D050177:Overweight / Q000150:complications / Q000453:epidemiology; D010146:Pain / Q000150:complications* / Q000453:epidemiology*; D010147:Pain Measurement; D011788:Quality of Life; D012189:Retrospective Studies; D012574:Schools; D012931:Social Environment; D016896:Treatment Outcome