title: Chronic pain in adolescents is associated with suicidal thoughts and behaviors.
abstract: Adults who suffer from chronic pain are at increased risk for suicide ideation and attempts, but it is not clear whether adolescents with chronic pain are similarly at elevated risk. This study investigates whether chronic pain is associated with an increase in suicidal ideation/attempts independent of depression in a population sample of adolescents. We analyzed data from the National Longitudinal Study of Adolescent Health, a longitudinal study of a nationally representative sample of adolescents in the United States (N = 9,970). Most chronic pain was related to suicide ideation/attempt both in the last year (odds ratio [OR] 1.3-2.1) and during the subsequent year (OR 1.2-1.8). After controlling for depressive symptoms, headaches (OR = 1.3 last year, OR = 1.2 subsequent year) and muscle aches (OR = 1.3 last year) remained associated with suicide ideation but not suicide attempt. These findings show that chronic pain in adolescence is a risk factor for suicide ideation; this effect is partly but not fully explained by depression. Youth with comorbid depression and chronic pain are at increased risk of thinking about and attempting suicide. Clinicians should be alert to suicide ideation/attempt and comorbid depression in this at-risk population.
  
  
  CONCLUSIONS
  Adolescents who suffer from chronic pain are at increased risk for suicide ideation and attempt. Depressive symptoms account for the link between chronic pain and suicide attempt, but do not completely explain why adolescents with chronic pain show suicide ideation.
authors.affiliation: University of North Carolina, Center for Functional GI and Motility Disorders, Chapel Hill, North Carolina 27516, USA. tilburg@med.unc.edu
authors.forename: Miranda A L
authors.initials: MA
authors.lastname: van Tilburg
authors.forename: Naomi J
authors.initials: NJ
authors.lastname: Spence
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
authors.forename: Shrikant
authors.initials: S
authors.lastname: Bangdiwala
authors.forename: David B
authors.initials: DB
authors.lastname: Goldston
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010146:Pain / Q000453:epidemiology* / Q000523:psychology*; D010147:Pain Measurement; D012189:Retrospective Studies; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology