Background & Aims
To address the global increase in chronic pain, research utilizing large, transgenerational cohorts, with a focus on epigenetic and psychosocial factors, can be of great value for the development of improved prevention and treatment approaches. The biopsychosocial model emphasizes the different domains and factors related to development and maintenance of chronic pain conditions. There are indications that pain and psychosocial factors such as stress are on the increase, especially in younger generations. The Malmö Offspring Pain Study (MOPS) initiated in 2018, is a transgenerational cohort study over three generations including assessment of both pain and psychosocial factors. The overarching goal of MOPS is to evaluate pain and risk factors associated to chronic pain over linked generations. The specific aim of the present study was to map pain, stress, and psychological well-being over three generations.
Methods
The present study on three generations of inhabitants in Malmö, Sweden is based on data from two studies: 1) the Malmö Offspring Pain Study (MOPS), a subset of the Malmö Offspring Study (MOS), and 2) the Malmö Shoulder and Neck Study (MSNS), a subset of the Malmö Diet and Cancer Study (MDCS). The index generation (Gen 0, aged 46-68yrs) consisted of 87% of the 14,556 participants in MSNS, n=12,607. Subsequent generations consisted of 1,436 children (Gen 1, aged 23-74yrs) and 799 grandchildren (Gen 2, aged 18-54yrs) from MOPS. Mental distress and psychological well-being were assessed by the General Health Questionnaire (GHQ-30) and stress by the Perceived Stress Scale (PSS-4). Pain was assessed by questionnaire and pain manikin. Descriptive statistics were computed for each generation and differences between genders were tested using independent sample T-test at alpha=0.05. The three generations were compared using one-way analysis of variance with Tukey’s test for post-hoc comparisons.
Results
The prevalence of neck pain was 19.6% in Gen 0, 41.9 % in Gen 1, and 30.3%, in Gen 2. The prevalence of back pain was 18.6% in Gen 0, 52.0% in Gen 1 and 33.7%, in Gen 2. Mean GHQ-30 scores varied between generations (all p<0.02); Gen 0 (26.33), Gen 1 (25.49), and Gen 2 (28.56). Compared to men, the GHQ-30 scores for women were higher in all generations; Gen 0 (27.33 vs 25.08, p<0.001), Gen 1 (26.66 vs 24.15, p<0.001), and Gen 2 (30.57 vs 25.62, p<0.001). Mean PSS-4 scores were higher in Gen 1 (7.51) and Gen 2 (7.92) compared to Gen 0 (4.48) (p<0.01). Compared to men, also the PSS scores for women were higher in all generations, Gen 0 (4.84 vs 4.03, p<0.001); Gen 1 (7.73 vs 7.25, p<0.001); and Gen 2 (8.07 vs 7.71, p<0.002).
Conclusions
Our findings indicate differences between generations in psychological well-being, perceived stress, and prevalence of neck and back pain. In comparison to the index generations, Gen 1 and Gen 2 reported higher levels of perceived stress and pain, suggesting a possible cohort-effect, that is influence of societal shifts and changing lifestyle. Later generations indicate higher prevalence of neck and back pain conditions compared to Gen 0, aligning with their higher stress and poorer mental health indicators. In addition, across the three generations, in comparison to men, women reported higher perceived stress scores and psychiatric symptoms, suggesting a consistent gender effect with regards to perceived stress and mental health. These variations underscore the complexity of psychosocial load and experiences across generations and between genders, requiring further investigations into possible cross-generational effects between individuals belonging to later generations.
References
Ostergren, P. O., Hanson, B. S., Balogh, I., Ektor-Andersen, J., Isacsson, A., Orbaek, P., Winkel, J., Isacsson, S. O., & Malmö Shoulder Neck Study Group (2005). Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort. Journal of epidemiology and community health, 59(9), 721–728. https://doi.org/10.1136/jech.2005.034801
Gummesson, C., Isacsson, S. O., Isacsson, A. H., Andersson, H. I., Ektor-Andersen, J., Ostergren, P. O., Hanson, B., & Malmö Shoulder-Neck Study group (2006). The transition of reported pain in different body regions–a one-year follow-up study. BMC musculoskeletal disorders, 7, 17. https://doi.org/10.1186/1471-2474-7-17
Presenting Author
Nikola Stanisic
Poster Authors
Nikola Stanisic
MSc
Malmo University. Faculty of Odontology
Lead Author
Sonia Sharma
BDS PhD
University of Michigan
Lead Author
Simon Vallin
MSc
Faculty of Medicine, Dep. of Odontology/Clinical Oral Physiology, Umeå University, Umeå, Sweden
Lead Author
Peter M Nilsson
MD/PhD
Dep. of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden.
Lead Author
Anna Lövgren
Umeå University
Lead Author
List Thomas
DDS
Orofacial Pain and Jaw Function, Malmö University, Sweden
Lead Author
Per-Olof Östergren
MD/PhD
Department of Social Medicine and Global Health, Lund University, Lund, Sweden.
Lead Author
Birgitta Häggman-Henrikson
Malmö University
Lead Author
Topics
- Epidemiology