Sex-specific impact of early-life adversity on chronic pain: a large population-based study in Japan

Abstract

Background

Responses to early-life adversity may differ by sex. We investigated the sex-specific impact of early-life adversity on chronic pain, chronic multisite pain, and somatizing tendency with chronic pain.

Methods

We examined 4229 respondents aged 20–79 years who participated in the Pain Associated Cross-Sectional Epidemiological Survey in Japan. Outcomes were: 1) chronic pain prevalence, 2) multisite pain (≥3 sites) prevalence, and 3) multiple somatic symptoms (≥3 symptoms) among respondents with chronic pain related to the presence or absence of early-life adversity.

Multivariable-adjusted odds ratios (ORs) were calculated with 95% confidence intervals using a logistic regression model including age, smoking status, exercise routine, sleep time, body mass index, household expenditure, and the full distribution of scores on the Mental Health Inventory-5. We further adjusted for pain intensity when we analyzed the data for respondents with chronic pain.

Results

The prevalence of chronic pain was higher among respondents reporting the presence of early-life adversity compared with those reporting its absence, with multivariable ORs of 1.62 (1.22–2.15, p<0.01) in men and 1.47 (1.13–1.90, p<0.01) in women. Among women with chronic pain, early-life adversity was associated with multisite pain and multiple somatic symptoms; multivariable ORs were 1.78 (1.22–2.60, p<0.01) for multisite pain and 1.89 (1.27–2.83, p<0.01) for ≥3 somatic symptoms. No associations were observed between early-life adversity and chronic multisite pain or multiple somatic symptoms among men with chronic pain.

Conclusion

Early-life adversity may be linked to a higher prevalence of chronic pain among both sexes and to multisite pain and somatizing tendency among women with chronic pain.

Keywords:

• sex characteristics
• early-life adversity
• chronic pain
• somatoform disorders
• disaster

Acknowledgments

We are grateful to Dr. Yasuo Takagi, professor of Keio University, Japan, for his valuable help in conducting the survey. We also express our appreciation to all of the participants of this study, and we thank Dr. Masayuki Yao, psychiatrist of Ranryo Hospital, Japan, and Dr. Kenta Wakaizumi, Keio University, Japan, for their professional advice.

Disclosure

The authors report no conflict of interest in this work.