Mental Health Comorbidities in Pediatric Chronic Pain: A Narrative Review of Epidemiology, Models, Neurobiological Mechanisms and Treatment
by
Jillian Vinall 1, Maria Pavlova 2, Gordon J. G. Asmundson 3, Nivez Rasic 1 and Melanie Noel 2,4,*
Jillian Vinall 1, Maria Pavlova 2, Gordon J. G. Asmundson 3, Nivez Rasic 1 and Melanie Noel 2,4,*
1
Department of Anesthesia, University of Calgary, Calgary, AB T3B 6A8, Canada
2
Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada
3
Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
4
Division of Behaviour and the Developing Brain, Alberta Children’s Hospital Research Institute, Calgary, AB T3B 6A8, Canada
*
Author to whom correspondence should be addressed.
Academic Editor: Sari A. Acra
Children 2016, 3(4), 40; https://doi.org/10.3390/children3040040
Received: 15 September 2016 / Revised: 15 November 2016 / Accepted: 21 November 2016 / Published: 2 December 2016
(This article belongs to the Special Issue Chronic and Recurrent Pain)
Chronic pain during childhood and adolescence can lead to persistent pain problems and mental health disorders into adulthood. Posttraumatic stress disorders and depressive and anxiety disorders are mental health conditions that co-occur at high rates in both adolescent and adult samples, and are linked to heightened impairment and disability. Comorbid chronic pain and psychopathology has been explained by the presence of shared neurobiology and mutually maintaining cognitive-affective and behavioral factors that lead to the development and/or maintenance of both conditions. Particularly within the pediatric chronic pain population, these factors are embedded within the broader context of the parent–child relationship. In this review, we will explore the epidemiology of, and current working models explaining, these comorbidities. Particular emphasis will be made on shared neurobiological mechanisms, given that the majority of previous research to date has centered on cognitive, affective, and behavioral mechanisms. Parental contributions to co-occurring chronic pain and psychopathology in childhood and adolescence will be discussed. Moreover, we will review current treatment recommendations and future directions for both research and practice. We argue that the integration of biological and behavioral approaches will be critical to sufficiently address why these comorbidities exist and how they can best be targeted in treatment.
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Keywords:
chronic pain; posttraumatic stress disorder; anxiety; depression; neurobiology; stress; brain; comorbidity; parent; intervention
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MDPI and ACS Style
Vinall, J.; Pavlova, M.; Asmundson, G.J.G.; Rasic, N.; Noel, M. Mental Health Comorbidities in Pediatric Chronic Pain: A Narrative Review of Epidemiology, Models, Neurobiological Mechanisms and Treatment. Children 2016, 3, 40.
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