Pain Catastrophizing May Predict Pain Medication Use Among Adolescents

Among adolescents with chronic pain, increased levels of pain catastrophizing were associated with more frequent pain medication use, according to results of a cross-sectional review published in Pain Medicine.

Investigators assessed associations between pain medication use and anxiety, depressive symptoms, and pain catastrophizing among adolescents with chronic pain. They further stratified these associations based on patients’ sex.

Data were taken from an ongoing epidemiological study including adolescents aged 12 to 18 years with chronic pain. Participants provided sociodemographic information and responded to assessments of pain location, frequency, intensity, and interference, as well as use of pain medication, anxiety, depressive symptoms, and catastrophizing about pain. Pain that lasted at least 3 months and occurred at least once per week was considered chronic.

A total of 320 adolescents reported having chronic pain and were included in the analysis. Sixty-three percent of participants were girls, back pain was the most common location (45%), and 78% of adolescents reported taking pain medication within the last 3 months to manage symptoms.

While both age and sex were considered predictors of pain medication use according to multivariable logistic regression, this effect was more strongly associated with sex. Girls were nearly 3 times more likely than boys to use pain medication.

However, when regression analysis was performed controlling for sex, pain intensity, and pain interference, the researchers found that sex had no moderating effect on the associations between psychological factors and pain medication use.

According to univariate analysis, anxiety, depressive symptoms, and catastrophizing about pain were significantly associated with pain medication use. However, multivariate regression analysis confirmed only catastrophizing about pain to be a unique independent predictor of pain medication use, after controlling for demographic variables (odds ratio, 1.1; P <.05).

This study was limited by its cross-sectional design, use of a convenience sample that may not be representative of the overall population, and application of a loose definition for pain medication use.

“The finding that pain catastrophizing predicted pain medication use over and above pain intensity and pain interference raises the possibility that adolescents with higher

levels of pain catastrophizing could be using pain medications misguidedly. Research to examine the impact of interventions targeting pain catastrophizing on pain medication use is warranted,” the study authors concluded.