Previous Mental Disorders and Subsequent Onset of Chronic Back or Neck pain: Findings from 19 Countries

Maria Carmen Viana, Carmen Lim, Flavia Garcia Pereira, Sergio Aguilar-Gaxiola, Jordi Alonso, Ronny Bruffaerts, Peter de Jonge, Jose Miguel Caldas-de-Almeida, SM O'Neill, Ali Al-Hamzawi, Dan Stein, Corina Benjet, Graca Cardoso, Silvia Florescu, Giovanni di Girolamo, Josep Maria Haro, Chiyi Hu, Viviane Kovess-Masfety, Daphna Levinson, Yoshibumi NakaneMarina Piazza, Jose Posada-Villa, Daniel Rabczenko, Ronald Kessler, Kate Scott

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)
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Associations between depression/anxiety and pain are well established, but its directionality is not clear. We examined the associations between temporally prior mental disorders and subsequent self-reported chronic back/neck pain onset, and investigated the variation in the strength of associations by timing of events during the life course, and by gender. Data were from population-based household surveys conducted in 19 countries (n=52,095). Lifetime prevalence and age-of-onset of 16 DSM-IV mental disorders, and the occurrence and age-of-onset of back/neck pain were assessed using the Composite International Diagnostic Interview. Survival analyses estimated the associations between first onset of mental disorders and subsequent back/neck pain onset. All mental disorders were positively associated with back/neck pain in bivariate analyses; most (12/16) remained so after adjusting for psychiatric comorbidity, with a clear dose-response relationship between number of mental disorders and subsequent pain. Early-onset disorders were stronger predictors of pain; when adjusting for psychiatric comorbidity, this remained the case for depression/dysthymia. No gender differences were observed. In conclusion, individuals with mental disorder, beyond depression and anxiety, are at higher risk of developing subsequent back/neck pain, stressing the importance of early detection of mental disorders, and highlight the need of assessing back/neck pain in mental health clinical settings.
Original languageEnglish
Pages (from-to)99-110
JournalThe Journal of Pain
Issue number1
Early online date12 Oct 2017
Publication statusPublished (in print/issue) - Jan 2018


  • back or neck pain
  • mental-physical comorbidity
  • psychiatric epidemiology
  • cross-national studies
  • mental health


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