Mid-Life Social and Health Outcomes Associated With Early-Onset Chronic Noncancer Pain: Findings from the Victorian Adolescent Health Cohort Study.

OBJECTIVES: Little is known about how those with early life experiences of chronic pain fare in middle adulthood. The current study examines the association of adolescent, young adult, and adult chronic pain onset with middle-aged sociodemographic, physical and mental health, and substance use profiles.

METHODS: The Victorian Adolescent Health Cohort Study (VAHCS) commenced in 1992 as a population-representative sample of 1943 14 to 15-year-old adolescents who have been followed across 11 waves into middle adulthood. We analysed data from Wave 11 (2019 to 2021, n=1412, age 43 years [mid-life]) to describe the midlife sociodemographic, physical and mental health, and substance use profiles of those who retrospectively reported adolescent (10 to 24 y), young adult (25 to 34 y), and adult (35 to 44 y) onset chronic pain. We also describe associations by sex at birth.

RESULTS: Two in 5 participants (41%) reported experiencing chronic pain by age 43 years. This was higher in females than in males (44.6% vs. 36.4%, respectively). Of these, just under half (45%) reported adolescent-onset chronic pain, 30% reported young adult-onset, and 25% reported adult-onset chronic pain. Compared with later onset pain, adolescent-onset was associated with a greater risk for financial hardship (particularly in males), past 12-month major illness, generalised anxiety disorder (among males), and more frequent cannabis use in mid-adult life.

DISCUSSION: Our findings suggest that chronic pain in midlife commonly starts early, across adolescence and young adulthood, and that many with earlier life histories of chronic pain are not faring well across a range of indicators in middle adult life, particularly those with the onset of chronic pain in adolescence.