Study: 9% of adolescents report experiencing both persistent pain and suicidality

Nearly one in 10 young people are experiencing both persistent physical pain and suicidal feelings, according to a new paper from researchers from the University of Oxford, Cambridge, Oslo (Norway), King's College London, and the Parc Sanitari Sant Joan de Deu (Spain).

Researchers say more awareness is needed across a range of health, social care, and school-based services in how to recognize suicidal risk, especially for those who also have physical pain and are more likely to come into contact with professionals.

The data came from more than 8,000 adolescents between the ages of 11 and 15 years across the UK who took part in the My Resilience in Adolescence (MYRIAD) trial. It showed that:

• Nine per cent of adolescents reported experiencing both persistent pain (persistent or recurrent pain in the past six months) and suicidality (ranging from thoughts about suicide and self-harm to the enactment of these thoughts).
• They were also shown to be at a higher risk of depression, anxiety, problems with their peers and more frequent use of prescription medication.
• Nearly three quarters of the group experiencing both pain and suicidality were girls (72.9 per cent).
• 20 per cent (one in five) of adolescents in the study reported suicidality and 22 per cent reported persistent or recurrent pain.

The paper highlighted that while many of those experiencing both pain and suicidality did access support services, fewer than half were in recent contact with their GP, and a quarter (26 per cent) were not accessing any support services at all.

The authors argue more needs to be done to ensure signs of suicidal risk were being picked up by professionals in contact with adolescents with pain.

With young people with both pain and suicidality accessing a range of services, it is vital there is more awareness of the increased suicidal risk in adolescents with persistent or recurrent pain.

Relevant training for health, social care and school-based professionals, focused on pain management, suicidal risk identification and appropriate referrals where necessary, could have a huge impact for young people with chronic pain by preventing suicidal risk progression.

We argue that a multi-sector approach is needed to really address suicidal risk including hospital and community-based health care, social care and school-based services."

Dr Verena Hinze, Oxford's Department of Psychiatry

She added: "Adolescents with both pain and suicidality reported higher levels of use of medication for pain and mental health difficulties, than adolescents reporting only pain or only suicidality. This access to prescription medication might increase suicidal capacity.

"Therefore, safety assessments and ongoing risk monitoring (including monitoring of prescribed medication load) in adolescents with pain and/or suicidality is crucial. But of course, active treatment for both pain and mental health conditions remains important to reduce distress and improve functioning," added Dr Hinze.

The MYRIAD trial was funded by the Wellcome Trust and supported by the National Institute for Health and Care Research Clinical Research Network. The researchers were supported by the Stiftung Oskar-Helene-Heim (Germany), the Institute of Health Carlos III (Spain), and the National Institute for Health and Care Research (UK). The funders had no role in the study design, data collection, analysis, and interpretation, or writing of the manuscript.

The paper is being published in eClinicalMedicine.