Adolescent chronic pain may lead to persistent disability and long-term health impairments in adulthood. However, our understanding of which youth are more likely to experience adverse outcomes remains limited. To address this gap, this longitudinal cohort study examined adolescent predictors of various dimensions of young adult health and functioning, including pain, physical health, depression, anxiety, social isolation, and sleep disturbance. As part of a previous clinical trial, we recruited a cohort of adolescents (ages 11-17 years, M age = 14 years) with non-disease-related chronic pain from 15 tertiary pain clinics in North America. Approximately 6 years later, 229 of the original 273 individuals (81% participation rate) completed a follow-up survey as young adults (ages 18-25 years, M age = 21 years). At the young adult follow-up, 73% reported continued chronic pain, with two-thirds experiencing moderate-to-severe pain interference. Youth reported several adverse health outcomes, including below-average physical health (37%), clinically elevated depression (42%), clinically elevated anxiety (48%), and sleep disturbances (77%). Multivariate regression analyses controlling for sociodemographic characteristics revealed that higher pain intensity, more pain locations, lower sleep quality, and greater anxiety symptoms in adolescence predicted worse pain outcomes in young adulthood. Moreover, lower sleep quality, greater anxiety symptoms, and worse family functioning predicted worse physical and psychosocial health in adulthood. These findings represent an important first step toward identifying ways to optimize psychological pain interventions. Tailored psychological pain interventions can directly target adolescent vulnerabilities, including mood, sleep, and family risk factors, with the potential to disrupt a lifelong trajectory of pain and suffering.

中文翻译：

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青少年疼痛和健康结果的预测因子：一项为期 6 年的前瞻性随访研究的结果。


青少年慢性疼痛可能导致成年后的持续残疾和长期健康损害。然而，我们对哪些青少年更有可能经历不良后果的理解仍然有限。为了解决这一差距，这项纵向队列研究检查了年轻人健康和功能各个维度的青少年预测因子，包括疼痛、身体健康、抑郁、焦虑、社交孤立和睡眠障碍。作为先前临床试验的一部分，我们从北美的 15 家三级疼痛诊所招募了一组患有非疾病相关慢性疼痛的青少年 （11-17 岁，M 年龄 = 14 岁）。大约 6 年后，最初的 229 人中有 273 人（81% 参与率）作为年轻人（年龄 18-25 岁，M 年龄 = 21 岁）完成了随访调查。在年轻成人随访中，73% 的人报告持续的慢性疼痛，其中三分之二的人经历了中度至重度疼痛干扰。青少年报告了几种不良的健康结果，包括低于平均水平的身体健康状况 （37%）、临床上升高的抑郁症 （42%）、临床上升高的焦虑 （48%） 和睡眠障碍 （77%）。控制社会人口学特征的多变量回归分析显示，青春期疼痛强度较高、疼痛部位较多、睡眠质量较低和焦虑症状较严重，预示着成年早期疼痛结局更严重。此外，睡眠质量较低、焦虑症状较严重和家庭功能较差预示着成年后的身体和社会心理健康状况较差。这些发现代表了确定优化心理疼痛干预方法的重要第一步。 量身定制的心理疼痛干预可以直接针对青少年的脆弱性，包括情绪、睡眠和家庭风险因素，有可能破坏终生的痛苦和痛苦轨迹。