Associations of Multisite Pain with Mental Ill Health Among Women in North India.
Keywords:pain, mental health, women, India, multisite body pain, depression, neuroses
Physical triggers of multisite pain (MSP) have typically been the focus if treatment regimens for MSP in low and middle income countries (LMICS). We explored the non-physical dimension of MSP, particularly the presence of mental ill health and other possible risk factors. We conducted a case-control study among 140 female participants in North India in early 2019. We used structured interviews to assess pain, and validated mental health questionnaires to determine presence of depression and neurotic disorders. Statistical analyses of multisite pain, mental health and demographic data found strong associations between multisite pain and depression and neurotic disorder. Marital status (women who had been widowed, separated or unmarried) was the only demographic factor found to have a significant association with the experience multisite pain. We conclude that non-physical factors such as mental health need to be considered by treating practitioners, and included within national treatment guidelines in LMICs such as India.
Gureje O, Von Korff M, Kola L, Demyttenaere K, He Y, Posada-Villa J, et al. The relation between multiple pains and mental disorders: results from the World Mental Health Surveys. PAIN®. 2008;135(1-2):82-91. http://doi.org/10.1016/j.pain.2007.05.005
Haukka E, Kaila‐Kangas L, Ojajärvi A, Saastamoinen P, Holtermann A, Jørgensen M, et al. Multisite musculoskeletal pain predicts medically certified disability retirement among F inns. Eur J Pain. 2015;19(8):1119-28. http://doi.org/10.1002/ejp.635
Vargas-Prada S, Coggon D. Psychological and psychosocial determinants of musculoskeletal pain and associated disability. Best Pract Res Clin Rheumatol. 2015;29(3):374-90. Epub 2015/11/28. http://doi.org/10.1016/j.berh.2015.03.003. PubMed PMID: 26612236; PubMed Central PMCID: PMC4668591.
James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789-858. http://doi.org/ 10.1016/S0140-6736(18)32279-7
Enright A, Goucke R. The global burden of pain: the tip of the iceberg? : LWW; 2016. http://doi.org/ 10.1213/ANE.0000000000001519
Engel GL. The need for a new medical model: a challenge for biomedicine. Psychodyn Psychiatry. 2012;40(3):377-96. http://doi.org/ 10.1126/science.847460
Endean A, Palmer KT, Coggon D. Potential of MRI findings to refine case definition for mechanical low back pain in epidemiological studies: a systematic review. Spine. 2011;36(2):160. http://doi.org/ 10.1097/BRS.0b013e3181cd9adb
Coggon D, Ntani G, Palmer KT, Felli VE, Harari R, Barrero LH, et al. Patterns of multisite pain and associations with risk factors. PAIN®. 2013;154(9):1769-77. http://doio.org/10.1016/j.pain.2013.05.039
Denkinger MD, Lukas A, Nikolaus T, Peter R, Franke S, Group AS. Multisite pain, pain frequency and pain severity are associated with depression in older adults: results from the ActiFE Ulm study. Age and ageing. 2014;43(4):510-4.
Kamaleri Y, Natvig B, Ihlebaek CM, Benth JS, Bruusgaard D. Number of pain sites is associated with demographic, lifestyle, and health‐related factors in the general population. Euro J Pain. 2008;12(6):742-8. http://doi.org/10.1016/j.ejpain.2007.11.005
Mundal I, Gråwe RW, Bjørngaard JH, Linaker OM, Fors EA. Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study. BMC Musculoskelet Di. 2014;15(1):213. http://doi.org/10.1186/1471-2474-15-213
Rios R, Zautra AJ. Socioeconomic disparities in pain: The role of economic hardship and daily financial worry. Health Psych. 2011;30(1):58. http://doi.org/ 10.1037/a0022025
Murthy RS. National mental health survey of India 2015–2016. Indian J Psychiat. 2017;59(1):21. http://doi.org/ 10.4103/psychiatry.IndianJPsychiatry_102_17
Herin F, Vézina M, Thaon I, Soulat J-M, Paris C. Predictive risk factors for chronic regional and multisite musculoskeletal pain: a 5-year prospective study in a working population. PAIN®. 2014;155(5):937-43. https://doi.org/10.1016/j.pain.2014.01.033
Nicholl BI, Mackay D, Cullen B, Martin DJ, Ul-Haq Z, Mair FS, et al. Chronic multisite pain in major depression and bipolar disorder: cross-sectional study of 149,611 participants in UK Biobank. BMC Psychiatry. 2014;14(1):350. http://doi.org/ 10.1186/s12888-014-0350-4
Patel V, Araya R, Chowdhary N, King M, Kirkwood B, Nayak S, et al. Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires. Psychol Med. 2008;38(2):221. http://doi.org/10.1017/S0033291707002334
Pfizer. PHQ and GAD-7 Instructions [27 Feb 2020]. Available from: www.phqscreeners.com/images/sites/g/files/g10016261/f/201412/instructions.pdf.
StataCorp. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP. 2015.
Kroenke K, Wu J, Bair MJ, Krebs EE, Damush TM, Tu W. Reciprocal relationship between pain and depression: a 12-month longitudinal analysis in primary care. J Pain. 2011;12(9):964-73. http://doi.org/10.1016/j.jpain.2011.03.003
Sadeghian F, Raei M, Ntani G, Coggon D. Predictors of incident and persistent neck/shoulder pain in Iranian workers: a cohort study. PLoS One. 2013;8(2). http://doi.org/0.1371/journal.pone.0057544
Solidaki E, Chatzi L, Bitsios P, Markatzi I, Plana E, Castro F, et al. Work-related and psychological determinants of multisite musculoskeletal pain. Scand J Work Env Hea. 2010;36(1):54-61.
Vargas-Prada S, Martínez JM, Coggon D, Delclos G, Benavides FG, Serra C. Health beliefs, low mood, and somatizing tendency: contribution to incidence and persistence of musculoskeletal pain with and without reported disability. Scand J Work Env Hea. 2013;39(6). http://doi.org/10.5271/sjweh.3377
Vranceanu A-M, Barsky A, Ring D. Psychosocial aspects of disabling musculoskeletal pain. JBJS. 2009;91(8):2014-8. http://doi.org/10.2106/JBJS.H.01512
Ganesh K. Knowledge and attitude of mental illness among general public of Southern India. Natl J Commun Med. 2011;2(1):175-8.
Shidhaye R, Kermode M. Stigma and discrimination as a barrier to mental health service utilization in India. Int Health. 2013;5(1):6-8. http://doi.org/ 10.1093/inthealth/ihs011
Panda P, Vyas N, Dsouza SM, Boyanagari VK. Determinants of chronic pain among adults in urban area of Udupi, Karnataka, India. Clin Epidemiol Global Health. 2019;7(2):141-4. http://doi.org/10.1016/j.cegh.2018.03.002
Mahfoudh A, Fennani K, Akrout M, Taoufik K. Determinants of occupational multisite musculoskeletal disorders: a cross sectional study among 254 patients. Reumatismo. 2018:92-9.
Mishra M, Srivastava AK, Srivastava VK. Prevalence and risk of musculoskeletal pain in rural homemakers of North India. Med J of Dr DY Patil University. 2017;10(2):138. http://doi.org/10.4103/0975-2870.202092
Balaji S, Hoq M, Velavan J, Raji B, Grace E, Bhattacharji S, et al. A multicentric cross-sectional study to characterize the scale and impact of polypharmacy in rural Indian communities, conducted as part of health workers training. J Family Med Primary Care. 2019;8(7):2234. http://doi.org/10.4103/jfmpc.jfmpc_410_19
Grills N, Velavan J, Balaji S, Grace E, Arun S, Raji B, et al. Opportunistic research in rural areas through community health worker training: a cost-effective method of researching medication misuse in rural India. Indian J Commun Health. 2016;28(1):28-34.
Porter G, Grills N. Medication misuse in India: a major public health issue in India. J Public Health. 2016;38(2). http://doi.org/10.1093/pubmed/fdv072
Derogatis LR, Melisaratos N. The brief symptom inventory: an introductory report. Psych Med. 1983;13(3):595-605.
Chowdhury A, Sanyal D, Bhattacharya A, Dutta S, De R, Banerjee S, et al. Prominence of symptoms and level of stigma among depressed patients in Calcutta. J Indian Med Asso. 2001;99(1):20-3. Available from: http://imsear.searo.who.int/handle/123456789/103846
How to Cite
Christian Journal for Global Health applies the Creative Commons Attribution License to all articles that we publish. Under this license, authors retain ownership of copyright for their articles or they can transfer copyright to their institution, but authors allow anyone without permission to copy, distribute, transmit, and/or adapt articles, even for commercial purposes so long as the original authors and Christian Journal for Global Health are appropriately cited.
This work is licensed under a Creative Commons Attribution 4.0 International License.