The association of self-injurious behaviour and suicide attempts with recurrent idiopathic pain in adolescents: evidence from a population-based study

Background: While several population-based studies report that pain is independently associated with higher rates of self-destructive behaviour (suicidal ideation, suicide attempts, and self-injurious behaviour) in adults, studies in adolescents are rare and limited to specific chronic pain conditions. The aim of this study was to investigate the link between self-reported idiopathic pain and the prevalence and frequency of self-injury (SI) and suicide attempts in adolescents. Methods: Data from a cross-sectional, school-based sample was derived to assess SI, suicide attempts, recurrent pain symptoms and various areas of emotional and behavioural problems via a self-report booklet including the Youth Self-Report (YSR). Adolescents were assigned to two groups (presence of pain vs. no pain) for analysis. Data from 5,504 students of 116 schools in a region of South Western Germany was available. A series of unadjusted and adjusted multinomial logistic regression models were performed to address the association of pain, SI, and suicide attempts. Results: 929 (16.88%) respondents reported recurrent pain in one of three areas of pain symptoms assessed (general pain, headache, and abdominal pain). Adolescents who reported pain also reported greater psychopathological distress on all sub-scales of the YSR. The presence of pain was significantly associated with an increased risk ratio (RR) for SI (1–3 incidences in the past year: RR: 2.96; >3 incidences: RR: 6.04) and suicide attempts (one attempt: RR: 3.63; multiple attempts: RR: 5.4) in unadjusted analysis. Similarly, increased RR was observed when adjusting for sociodemographic variables. While controlling for psychopathology attenuated this association, it remained significant (RRs: 1.4–1.8). Sub-sequent sensitivity analysis revealed different RR by location and frequency of pain symptoms. Conclusions: Adolescents with recurrent idiopathic pain are more likely to report previous incidents of SI and suicide attempts. This association is likely mediated by the presence of psychopathological distress as consequence of recurrent idiopathic pain. However, the observed variance in dependent variables is only partially explained by emotional and behavioural problems. Clinicians should be aware of these associations and interview adolescents with recurrent symptoms of pain for the presence of self-harm, past suicide attempts and current suicidal thoughts. Future studies addressing the neurobiology underpinnings of an increased likelihood for self-injurious behaviour and suicide attempts in adolescents with recurrent idiopathic pain are necessary

I Need to Hear Some Sounds That Recognize the Pain in Me: An Integrative Review of a Decade of Research in the Development of Active Music Therapy Outpatient Treatment in Patients With Recurrent or Chronic Pain

Music is widely used to reduce pain in a broad variety of clients and settings. Most studies focus on the pain-reducing effect of music-listening interventions on patients with acute pain, whereas studies investigating the effect of active therapy (ie, music making) on pain perception in patients with recurrent or chronic pain are rare. This article reviews the findings of a series of previously published studies by our work group, conducted during the past 10 years, using defined music therapy plans in the treatment of outpatients with conditions of recurrent or chronic pain. This review provides evidence that a specific music therapy concept tailored to the demands of the patient might be able to substantially reduce pain frequency and pain intensity in patients with recurrent or chronic pain. However, further studies need to investigate the nature of those beneficial effects and their specificity. [PUBLICATION ABSTRACT

Additional file 1 of Systemic therapy in children and adolescents with mental disorders: a systematic review and meta-analysis

Supplementary file 1: Additional file 1. PRISMA 2020 Checklist. Additional file 2. Search strategies. Additional file 3. Study pool of included RCTs. Additional file 4. Characteristics of included RCTs. Additional file 5. Risk-of-bias assessment. Additional file 6. All results