Abstract
The aim of this study was to estimate the prevalence of parent-reported pain among children in the Nordic countries in 1996, and to describe the association between recurrent pain in children and parental socio-economic factors. We also wanted to estimate the association between parental pain and childhood pain and co-occurrence of different pain patterns in the same child. Data were obtained from a cross-sectional survey on children's health and well-being in the Nordic countries in 1996. About 10, 000 children aged 2–17 years of age were selected from population registries. Mean response rate was 68%. We selected the cases ≥7 years where the respondent was the child's biological mother or father, yielding a total of 6230 subjects. The adjusted analyses were performed using logistic regression in SPSS. The total prevalence of headache, abdominal pain and back pain among children 7–17 years of age was 14.9, 8.3 and 4.7%, respectively. The most common pain combination was headache and abdominal pain. Pain was most frequent among girls. The prevalence was slightly higher in low educated or low-income families compared to those of high status. Children living in low educated, low-income, worker families had approximately a 1.4-fold odds of having pain. There was a strong association between the different pain conditions, and between pain and other forms of distress in the same child. A site-specific association between parental and child pain was also shown, but we assume that this might have been mediated through subjective (information) bias.
References
Kristjansdottir G. Prevalence of pain combinations and overall pain: A study of headache, stomach pain and back pain among school-children. Scand J Soc Med 1997; 25: 58–63.
Kristjansdottir G. Recurrent pains - a public health concern in school-age children. An Investigation of Headache, Stomach Pain and Back Pain, Göteborg, Sweden: The Nordic School of Public Health, 1996.
Merskey H. Classification of chronic pain: Descriptions of chronic pain syndroms and definitions of pain terms. Pain 1986; (Suppl 3).
McGrath PJ. Annotation: Aspects of pain in children and adolescents. J Child Psychol Psychiatry 1995; 36: 717–730.
Fearon P, Hotopf M. Relation between headache in childhood and physical and psychiatric symptoms in adulthood: National birth cohort study. Br Med J 2001; 322: 1145.
Walker LS, Guite JW, Duke M, Barnard JA, Greene JW. Recurrent abdominal pain: A potential precursor of irritable bowel syndrome in adolescents and young adults. J Pediatr 1998; 132: 1010–1015.
Hotopf M, Carr S, Mayou R, Wadsworth M, Wessely S. Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study. Br Med J 1998; 316: 1196–1200.
Hunfeld JA, Perquin CW, Bertina W, et al. Stability of pain parameters and pain-related quality of life in adolescents with persistent pain: A three-year follow-up. Clin J Pain 2002; 18: 99–106.
Hunfeld JA, Perquin CW, Duivenvoorden HJ, et al. Chronic pain and its impact on quality of life in adolescents and their families. J Pediatr Psychol 2001; 26: 145–153.
Borge AI, Nordhagen R, Moe B, Botten G, Bakketeig LS. Prevalence and persistence of stomach ache and headache among children. Follow-up of a cohort of Norwegian children from 4 to 10 years of age. Acta Paediatr 1994; 83: 433–437.
Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA, et al. Pain in children and adolescents: A common experience. Pain 2000; 87: 51–58.
Kristjansdottir G, Wahlberg V. Sociodemographic differences in the prevalence of self-reported headache in Icelandic school-children. Headache 1993; 33: 376–380.
Kristjansdottir G. Sociodemographic differences in the prevalence of self-reported stomach pain in school children. Eur J Pediatr 1996; 155: 981–983.
Kristjansdottir G. Prevalence of self-reported back pain in school children: A study of sociodemographic differences. Eur J Pediatr 1996; 155: 984–986.
Goodman JE, McGrath PJ. The epidemiology of pain in children and adolescents: A review. (Review) (66 refs). Pain 1991; 46: 247–264.
Oster J. Recurrent abdominal pain, headache and limb pains in children and adolescents. Pediatrics 1972; 50: 429–436.
Taimela S, Kujala UM, Salminen JJ, Viljanen T. The prevalence of low back pain among children and adolescents. A nationwide, cohort-based questionnaire survey in Finland. Spine 1997; 22: 1132–1136.
Smedbråten BK, Natvig B, Rutle O, Bruusgaard D. Self-reported bodily pain in schoolchildren. Scand J Rheumatol 1998; 27: 273–276.
Borge AI, Nordhagen R. Recurrent pain symptoms in children and parents. Acta Paediatr 2000; 89: 1479–1483.
Mikkelsson M, Salminen JJ, Kautiainen H. Non-specific musculoskeletal pain in preadolescents. Prevalence and 1-year persistence. Pain 1997; 73: 29–35.
Vikat A, Rimpela M, Salminen JJ, Rimpela A, Savolainen A, Virtanen SM. Neck or shoulder pain and low back pain in Finnish adolescents. Scand J Public Health 2000; 28: 164–173.
Moro E. Uber rezidivierende Nabelnkoliken bei älteren Kindern. Munch Medizin Wochen 1913; 60: 2827–2829.
Apley J. Pain in childhood. J Psychosom Res 1976; 20: 383–389.
Anttila P, Metsahonkala L, Mikkelsson M, Helenius H, Sillanpaa M. Comorbidity of other pains in school children with migraine or nonmigrainous headache. J Pediatr 2001; 138: 176–180.
Kristjansdottir G. The relationship between pains and various discomforts in schoolchildren. Childhood 1997; 4: 491–504.
Osborne RB, Hatcher JW, Richtsmeier AJ. The role of social modeling in unexplained pediatric pain. J Pediatr Psychol 1989; 14: 43–61.
Edwards PW, Zeichner A, Kuczmierczyk AR, Boczkowski J. Familial pain models: The relationship between family history of pain and current pain experience. Pain 1985; 21: 379–384.
Lau RR, Quadrel MJ, Hartman KA. Development and change of young adults' preventive health beliefs and behavior: Influence from parents and peers. J Health Soc Behav 1990; 31: 240–259.
Kristjansdottir G. Familial aggregation and pain theory relating to recurrent pain experiences in children. Acta Paediatr 2000; 89: 1403–1405.
Aromaa M, Sillanpaa M, Rautava P, Helenius H. Pain experience of children with headache and their families: A controlled study. Pediatrics 2000; 106: 270–275.
Power C. Health and social inequality in Europe (see comments). Br Med J 1994; 308: 1153–1156.
Mikkelsson M, Sourander A, Salminen JJ, Kautiainen H, Piha J. Widespread pain and neck pain in schoolchildren. A prospective one-year follow-up study. Acta Paediatr 1999; 88: 1119–1124.
Mikkelsson M, Sourander A, Piha J, Salminen JJ. Psychiatric symptoms in preadolescents with musculoskeletal pain and fibromyalgia. Pediatrics 1997; 100: 220–227.
Sillanpaa M, Piekkala P, Kero P. Prevalence of headache at preschool age in an unselected child population. Cephalalgia 1991; 11: 239–242.
Leboeuf-Yde C, Wedderkopp N, Andersen LB, Froberg K, Hansen HS. Back pain reporting in children and adolescents: The impact of parents' educational level. J Manipulative Physiol Ther 2002; 25: 216–220.
Teigum HM. Barns helse og velferd 1996. Dokumentasjon og frafallsanalyse. Oslo-Kongsvinger: Statistisk sentralbyrå, 1997; 97/64.
Berntsson L. Health and Well-being of Children in the Five Nordic Countries in 1984 and 1996. Göteborg, Sweden: Nordic School of Public Health, 2000.
Swedish socio-economic classification (SEI). Stockholm, Statistics, Sweden (SCB). 1982; 4.
Fokus 2000. Oslo: Kunnskapsforlaget, 2000.
Stata. Stata Corp. 2001. Stata Statistical software: Release 7.0. College Station. TX: Stata Corporation, 2001.
Hosmer DW, Lemeshow S. Applied Logistic Regression. New York: John Wiley & Sons, 1989.
Grøholt EK, Stigum H, Nordhagen R. Children with chronic health conditions in the Nordic countries in 1996 - influence of socio-economic factors. Ambulatory Child Health 2001; 7: 177–189.
Grøholt EK, Stigum H, Nordhagen R, Köhler L. Health service utilsation in the Nordic countries in 1996 - influence of socio-economic factors among children with and without chronic health conditions. Eur J Publ Health, In press.
Groholt EK, Nordhagen R. Differences in health and use of health services among Nordic children according to parental education. Nor J Epidemiol 2002; 12: 47–54.
Sweeting H, West P. Health at age 11: Reports from schoolchildren and their parents. Arch Dis Child 1998; 78: 427–434.
Alfven G. The covariation of common psychosomatic symptoms among children from socio-economically differing residential areas. An epidemiological study. Acta Paediatr 1993; 82: 484–487.
Waters E, Doyle J, Wolfe R, Wright M, Wake M, Salmon L. Influence of parental gender and self-reported health and illness on parent-reported child health. Pediatrics 2000; 106: 1422–1428.
Borge AI, Samuelsen SO, Rutter M. Observer variance within families: Confluence among maternal, paternal and child ratings. Int J Meth Psych Res 1999; 10: 12–21.
Verhulst FC, van der EJ. Agreement between parents' reports and adolescents' self-reports of problem behavior. J Child Psychol Psychiatry 1992; 33: 1011–1023.
Garber J, Van Slyke DA, Walker LS. Concordance between mothers' and children's reports of somatic and emotional symptoms in patients with recurrent abdominal pain or emotional disorders. J Abnorm Child Psychol 1998; 26: 381–391.
Hertzberg A. Prediction of cervical and low-back pain based on routine school health examinations. A nineto twelve-year follow-up study. Scand J Prim Health Care 1985; 3: 247–253.
Salminen JJ, Oksanen A, Maki P, Pentti J, Kujala UM. Leisure time physical activity in the young. Correlation with low-back pain, spinal mobility and trunk muscle strength in 15-year-old school children. Int J Sports Med 1993; 14: 406–410.
Honeyman PT, Jacobs EA. Effects of culture on back pain in Australian aboriginals. Spine 1996; 21: 841–843.
Abu-Saad H. Cultural group indicators of pain in children. Maternal-Child Nurs J 1984; 13: 187–196.
Blane D, Power C, Bartley M. Illness behaviour and the measurement of class differentials in morbidity. J Roy Stat Soc Series A 1996; 159: 77–92.
Van der Velden J, Abrahamse H, Donker G, Van der Steen J, Van Sonsbeek J, Van den Bos G. What do health interview surveys tell us about about the prevalences of somatic chronic diseases? A study in concurrent validity. Eur J Publ Health 1998; 8: 52–58.
Elstad J. How large are the differences-really? Self-reported long standing illness among working class and middle class men. Sociol Health Ill 1996; 18: 475–498.
Halldorsson M, Kunst AE, Köhler L, Mackenbach JP. Socioeconomic inequalities in the health of children and adolescents. A comparartive study of the five Nordic countries. Eur J Publ Health 2000; 10: 281–288.
Alfven G. Understanding the nature of multiple pains in children. J Pediatr 2001; 138: 156–158.
Alfven G. (Psychosomatic pain in children - a psychomuscular stress reaction?). (Review) (15 refs) (Swedish). Nordisk Medicin 1995; 110: 275–279.
Woolf CJ. Generation of acute pain: Central mechanisms. (Review) (27 refs). Br Med Bull 1991; 47: 523–533.
Watson D, Pennebaker JW. Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychol Rev 1989; 96: 234–254.
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Grøholt, EK., Stigum, H., Nordhagen, R. et al. Recurrent pain in children, socio-economic factors and accumulation in families. Eur J Epidemiol 18, 965–975 (2003). https://doi.org/10.1023/A:1025889912964
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DOI: https://doi.org/10.1023/A:1025889912964