Comorbidity and familial aggregation of back/neck pain in the NIMH Family Study of Affective Spectrum Disorders

• Published in: Journal of psychosomatic research Vol. 158; p. 110927
• Main Authors: Stapp, Emma K., Cui, Lihong, Guo, Wei, Paksarian, Diana, Merikangas, Kathleen R.
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.07.2022; Elsevier Science Ltd
• Subjects: Age of onset; Back pain; Bipolar disorder; Comorbidity; Depressive personality disorders; Emotional disorders; Familial factors; Heredity; Heritability; Mental depression; Mood; Mood disorders; Neck; Neck pain; Pain; Prevention programs; Relatives; Risk factors; Subtypes; Neck pain; Mood disorders; Bipolar disorder; Back pain; Comorbidity
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2022.110927

Back pain is associated with substantial Global Burden of Disease and is highly comorbid with mood and anxiety symptoms and syndromes. However, mechanisms underlying this association have not been well-elucidated. Here we apply data from the NIMH Family Study of Affective Spectrum Disorders to investigate the comorbidity, familial aggregation, and cross-aggregation of back/neck pain with mood disorder subtypes. The sample includes 519 probands and 560 interviewed first-degree relatives. Lifetime DSM-IV Bipolar I, Bipolar II, and Major Depressive Disorder [MDD] were derived from semi-structured diagnostic interviews. Lifetime history of back or neck pain and its age of onset were self-reported retrospectively. Familial aggregation and cross-aggregation were estimated via mixed effects models in probands and interviewed first-degree relatives, while heritability and co-heritability (endophenotypic ranking value [ERV]) were estimated using full pedigrees. Over 45% of participants endorsed a history of back/neck pain. Back/neck pain was familial (adjusted odds ratio [aOR] 1.5, p = 0.04; h2 = 0.24, p = 0.009). Back/neck pain in probands was associated with MDD in relatives (aOR 1.5, p = 0.04; ERV = 0.17, p = 0.024), but not with bipolar disorder. Onset of back/neck pain occurred earlier in those with bipolar disorder compared to controls. Findings suggest common familial risk factors underlying back/neck pain with MDD, whereas there was within-individual comorbidity of bipolar with back/neck pain. Future studies that identify common factors that lead to either back/neck pain or MDD can inform prevention and interventions. •A history of back or neck pain is common in the community.•Risk of back/neck pain is higher in those whose relatives have back/neck pain.•Back/neck pain and major depression travel together in families.•Back/neck pain occurs approximately a decade earlier in those with bipolar disorder.•Back/neck pain may be a sequela of bipolar disorder, which merits intervention.