title: Chronic pain, activity restriction and flourishing mental health.
abstract: BACKGROUND
  According to the activity restriction (AR) model, a potential explanation for the impact of chronic pain on mental illness is that pain contributes to depression by limiting usual activities. This study uses a measure of mental health (flourishing), rather than mental illness to examine associations between pain and activity restrictions.
  
  
  METHODS
  Data from the 2011/2012 Canadian Community Health Survey were used to study the relationship between pain intensity, pain-related activity prevention, and flourishing mental health in people aged 18 or older. Multivariate logistic regression was used in a sample of 26,429 people with chronic pain to identify significant relationships, while adjusting for potential confounders.
  
  
  RESULTS
  In 2011/2012, an estimated 6 million Canadians aged 18 or older (22%) reported chronic pain. They were less likely to be in flourishing mental health than were people without chronic pain (69% versus 79%). The prevalence of flourishing mental health declined as pain intensity and the number of activities prevented because of pain increased. Pain intensity and pain-related activity prevention were each independently associated with flourishing mental health, even when socio-demographic and health factors were taken into account. Pain-related activity prevention partially mediated the association between pain intensity and flourishing mental health.
  
  
  CONCLUSIONS
  The results of this study support the AR model and highlight the importance of both pain intensity and activity restriction in relation to flourishing mental health.
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
authors.forename: Heather
authors.initials: H
authors.lastname: Gilmour
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D059350:Chronic Pain / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D012720:Severity of Illness Index; D058992:Social Participation; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Positive Mental Health Continuum — Short Form (MHC-SF); cross-sectional study; health survey