Childhood behaviour linked to future risk of chronic pain

Published on 10 Mar 2010

Children who exhibit behavioural problems may be more likely to suffer from chronic widespread pain in adulthood, a new study has found.

Previous research has suggested that severe adverse events in childhood - such as hospitalisation or separation from mothers - may be linked to chronic widespread pain, but this is thought to be the first study to look at the impact of childhood behaviour on future risk.

Scientists at the University of Aberdeen, led by epidemiologist Dr Dong Pang, followed 18,558 children, all of whom were born in a single week in 1958 in England, Scotland or Wales.

They also studied a further 920 children who were born overseas in the same week and later moved to the UK.

Behavioural reports were prepared by asking parents and teachers about restlessness, worrying, loneliness, obedience, stealing, bullying and other aspects of behaviour.

At age 45, participants completed a questionnaire asking about their experiences of pain in adult life.

The researchers found that children whose teachers had reported severe behavioural problems at ages seven, 11 and 16 were more than twice as likely to have chronic widespread pain in adulthood as those who had been well-behaved.

There was also a slight link between parent-reported behaviour and future risk of chronic pain and researchers believe that the discrepancies are due to parents being less objective.

Analysis also revealed that chronic widespread pain was slightly more common in women than in men.

The study authors, whose findings are published in the journal Rheumatology, believe that the association may be explained by an interaction between the nervous system and hormones in early life.

"Until now, it was unknown whether maladjusted behaviour in children was a long-term marker for chronic widespread pain in adulthood. Our study shows that it is," said Dr Pang.

"Early life experience, such as emotional stress due to past trauma, may have a lifelong impact on the neuroendocrine system, which in turn leads to behavioural problems in childhood and chronic widespread pain in adulthood, as well as other mental problems."

The researcher said that further studies are needed to clarify this theory.

Professor Alan Silman, medical director of Arthritis Research UK, said the results of the study were not surprising in the light of previous research.

"We have shown that psychological issues in childhood strongly influence the risk of chronic pain, in that children with social problems - and problems with their friends and peers - are associated with suffering from chronic musculoskeletal pain, and that these psychological factors are more important than things like the weight of their school bags or sporting activities.

"We also know that people who have chronic pain problems as adults had pain problems as children. Therefore putting this picture together, it's not surprising that behavioural problems in children lead to chronic pain in adulthood."

Professor Silman added that Arthritis Research UK research had also shown that childhood physical and sexual abuse was associated with chronic widespread pain.

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