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The Course of Chronic Pain With and Without Psychiatric Disorders: A 6-Year Follow-Up Study From Childhood to Adolescence and Young Adulthood
Objective: Psychiatric disorders are common in children with chronic pain, but their course and impact when children grow up are unknown. This study examines the 6-year clinical outcome of children referred for chronic pain with and without comorbid psychiatric disorders.
Method: In 91 children and adolescents (aged 8 to 17 years) referred to a university outpatient clinic for chronic pain, child psychiatric disorders were assessed using the Diagnostic Interview Schedule for Children-parent version (DISC-P) between 2000 and 2002. Participants (aged 13 to 24 years) were reassessed on average 6-years later. Outcome measures were chronic pain and psychiatric disorders assessed with the Diagnostic Interview Schedule for Children-children version (DISC-C) or the Composite International Diagnostic Interview (CIDI) and Diagnostic Interview Schedule IV (DIS).
Results: After 6 years, 75% of the participants still experienced chronic pain and 15% were in complete remission of both chronic pain and psychiatric disorder. The prevalence of psychiatric disorders (both persistent and new onset disorders) at follow-up was 32%. Baseline psychiatric disorder was a predictor of psychiatric disorder at follow-up (OR = 2.6, 95% CI = 1.1–6.5, P = .04; adjusted OR = 2.8, 95% CI = 1.1–7.1, P = .03) but did not predict persistence of chronic pain.
Conclusions: Children referred for chronic pain frequently continue to suffer from chronic pain and psychiatric disorders in adolescence and young adulthood. In this population, comorbid psychiatric disorder at study entry was a predictor of psychiatric disorder, but not of persistent chronic pain, in adolescence and young adulthood.
J Clin Psychiatry 2012;73(1):e134–e139
© Copyright 2012 Physicians Postgraduate Press, Inc.
Submitted: November 30, 2010; accepted May 27, 2011 (doi:10.4088/JCP.10m06751).
Corresponding author: Lidewij M. E. Knook, MD, Dept Child and Adolescent Psychiatry, B 01.201, University Medical Centre Utrecht, PO Box 85500, 3508 GA, The Netherlands (L.M.E.Knook@umcutrecht.nl).