title: A greater number of somatic pain sites is associated with poor mental health in adolescents: a cross-sectional study.
abstract: BACKGROUND
  Identifying indicators of poor mental health during adolescence is a significant public health issue. Previous studies which suggested an association between the number of somatic pains and depression have mainly focused on adults or have employed samples with a narrow age range. To date, results from previous studies have been inconsistent regarding the association between somatic pain and academic impairment. Therefore, the main aims of the present study were to 1) investigate the association between the number of somatic pain sites and poor mental health using a community sample of adolescents aged 12 to 18 years and employing a simple method of assessment, and 2) examine the association between the number of somatic pain sites and perceived academic impairment.
  
  
  METHODS
  Data analysis was conducted using a large cross-sectional survey of adolescents in grades 7 to 12. The one-month prevalence rates for three sites of somatic pain including head, neck and shoulders, and abdomen were examined. Poor mental health was evaluated using the General Health Questionnaire, and perceived academic impairment was measured using a self-report questionnaire.
  
  
  RESULTS
  A total of 18,104 adolescents participated in the survey. A greater number of pain sites was associated with poor mental health, and this association was consistent across age and gender. There was no difference in effect on mental health between any of the pain sites. Although there was an association between the number of somatic pain sites and perceived academic impairment, the results suggested that the association was mediated by poor mental health.
  
  
  CONCLUSIONS
  Simple reporting methods for assessing the number of pain sites may be a feasible indicator of poor mental health in adolescents. Professionals working with adolescents should consider the possibility of poor mental health, especially when students report multiple somatic pains.
authors: Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors: Shuntaro
authors: S
authors: Ando
authors: Syudo
authors: S
authors: Yamasaki
authors: Shinji
authors: S
authors: Shimodera
authors: Tsukasa
authors: T
authors: Sasaki
authors: Norihito
authors: N
authors: Oshima
authors: Toshi A
authors: TA
authors: Furukawa
authors: Nozomu
authors: N
authors: Asukai
authors: Kiyoto
authors: K
authors: Kasai
authors: Yoshio
authors: Y
authors: Mino
authors: Shimpei
authors: S
authors: Inoue
authors: Yuji
authors: Y
authors: Okazaki
authors: Atsushi
authors: A
authors: Nishida
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology; D000293:Adolescent; D000367:Age Factors; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D019547:Neck Pain / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D020069:Shoulder Pain / Q000453:epidemiology