In search of risk factors for chronic pain in adolescents: a case-control study of childhood and parental associations.
OBJECTIVE
This study was designed to investigate whether an individual and parental history of functional pain syndromes (FPS) is found more often in adolescents suffering from chronic pain than in their pain-free peers.


METHODS
Our case-control study involved 101 adolescents aged 10-18 years. Cases were 45 patients of the Chronic Pain Clinic at Sydney Children's Hospital with diverse chronic pain disorders. Controls consisted of 56 adolescent volunteers who did not have chronic pain. Adolescents and their parents filled out questionnaires assessing demographic data as well as known and potential risk factors for chronic pain. A history of FPS was assessed by questionnaire, including restless legs syndrome (RLS). Chi-squared tests and t-tests were used to investigate univariate associations between chronic pain in adolescents and lifetime prevalence of FPS. Logistic regression was used to test multivariate associations, while controlling for possible confounders.


RESULTS
Migraine, non-migraine headaches, recurrent abdominal pain (RAP), and RLS were reported significantly more frequently in cases than controls (P-values of 0.01, <0.001, 0.01, and 0.03, respectively). Parental migraine, RAP, and RLS were also significantly associated with adolescent chronic pain in the multivariate analyses. Individual history of migraine, non-migraine headaches, and RAP, along with parental history of RAP and depression significantly accounted for 36%-49% of variance in chronic pain. Other associations with chronic pain were generally in accordance with previous reports.


CONCLUSIONS
It may be helpful when assessing a child who has chronic pain or is at risk of chronic pain, to enquire about these associations. Based on the current findings, an individual history of migraine, non-migraine headaches, and RAP, as well as parental migraine, RAP, and RLS are symptoms that are of particular relevance to assess.
University of Groningen, Groningen, The Netherlands.
Alies
A
Coenders
Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia.
Cindy
C
Chapman
University of New South Wales, Kensington, NSW, Australia.
Patricia
P
Hannaford
Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia ; University of New South Wales, Kensington, NSW, Australia.
Tiina
T
Jaaniste
Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia.
Wen
W
Qiu
Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia.
David
D
Anderson
Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia.
Maline
M
Glogauer
Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia.
Evelyn
E
Goodison-Farnsworth
Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia.
Marianne
M
McCormick
Department of Anaesthesia and Pain Medicine, Sydney Children's Hospital, Randwick, NSW, Australia ; University of New South Wales, Kensington, NSW, Australia.
David
D
Champion
adolescents; chronic adolescent pain; functional pain syndromes; parental history; restless legs syndrome