Over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway

Abstract Background Over-the-counter analgesics (OTCA) such as Paracetamol and Ibuprofen are frequently used by adolescents, and the route of administration and access at home allows unsupervised use. Psychological distress and pain occur simultaneously and are more common among females than among m...

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Autores principales:	Rune Jonassen, Eva Hilland, Catherine J. Harmer, Dawit S. Abebe, Anne Kristine Bergem, Siv Skarstein
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Over-the-counter analgesics Psychological distress Pain Sex differences Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/f8d50d0fd3a54e4891f315c55ef1a844
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spelling	oai:doaj.org-article:f8d50d0fd3a54e4891f315c55ef1a8442021-11-08T10:43:32ZOver-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway10.1186/s12889-021-12054-31471-2458https://doaj.org/article/f8d50d0fd3a54e4891f315c55ef1a8442021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12054-3https://doaj.org/toc/1471-2458Abstract Background Over-the-counter analgesics (OTCA) such as Paracetamol and Ibuprofen are frequently used by adolescents, and the route of administration and access at home allows unsupervised use. Psychological distress and pain occur simultaneously and are more common among females than among males. There is a dynamic interplay between on-label pain indications and psychological distress, and frequent OTCA use or misuse can exacerbate symptoms. No studies have to date provided an overview of frequent OTCA use in a larger population-based study. The current study used survey data to explore associations between and the relative predictive value of on-label pain indication and measures of psychological distress, together with sex differences for weekly OTCA use. Methods This study included 349,528 adolescents aged 13–19. The data was collected annually between January 2014 and December 2018 as part of the Norwegian Young Data survey. Performance analysis was conducted to explore the relative roles and associations between on-label pain indication and psychological distress in weekly OTCA use. A mixed-effects logistic regression model was used to explore the unique contributions from four domains of on-label pain indication and psychological distress as measured by a combined measure of anxiety and depression (HSCL-10) and peer-bullying involvement as victims or bullies. Results Thirty percent of females and 13 % of males use OTCA weekly. Headache is the strongest on-label pain predictor of weekly OTCA use, followed by abdominal pain. Depression and anxiety are the strongest psychological predictor of weekly OTCA use, and higher symptom levels and being female increase the strength of this association. Anxiety and depression also predict weekly OTCA use after controlling for physiological pain. Conclusions Sex, pain and anxiety and depression are inter-correlated and strong predictors of frequent OTCA use. Frequent OTCA use in the context of psychological distress may be a form of self-medication that can exacerbate symptoms and decrease psychosocial function. Longitudinal studies that explore causal trajectories between frequent on-label OTCA use and psychological distress are required. OTCA use among adolescents, and particularly among females, with anxiety and depression should be administered with caution and closely monitored.Rune JonassenEva HillandCatherine J. HarmerDawit S. AbebeAnne Kristine BergemSiv SkarsteinBMCarticleOver-the-counter analgesicsPsychological distressPainSex differencesPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Over-the-counter analgesics Psychological distress Pain Sex differences Public aspects of medicine RA1-1270
spellingShingle	Over-the-counter analgesics Psychological distress Pain Sex differences Public aspects of medicine RA1-1270 Rune Jonassen Eva Hilland Catherine J. Harmer Dawit S. Abebe Anne Kristine Bergem Siv Skarstein Over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway
description	Abstract Background Over-the-counter analgesics (OTCA) such as Paracetamol and Ibuprofen are frequently used by adolescents, and the route of administration and access at home allows unsupervised use. Psychological distress and pain occur simultaneously and are more common among females than among males. There is a dynamic interplay between on-label pain indications and psychological distress, and frequent OTCA use or misuse can exacerbate symptoms. No studies have to date provided an overview of frequent OTCA use in a larger population-based study. The current study used survey data to explore associations between and the relative predictive value of on-label pain indication and measures of psychological distress, together with sex differences for weekly OTCA use. Methods This study included 349,528 adolescents aged 13–19. The data was collected annually between January 2014 and December 2018 as part of the Norwegian Young Data survey. Performance analysis was conducted to explore the relative roles and associations between on-label pain indication and psychological distress in weekly OTCA use. A mixed-effects logistic regression model was used to explore the unique contributions from four domains of on-label pain indication and psychological distress as measured by a combined measure of anxiety and depression (HSCL-10) and peer-bullying involvement as victims or bullies. Results Thirty percent of females and 13 % of males use OTCA weekly. Headache is the strongest on-label pain predictor of weekly OTCA use, followed by abdominal pain. Depression and anxiety are the strongest psychological predictor of weekly OTCA use, and higher symptom levels and being female increase the strength of this association. Anxiety and depression also predict weekly OTCA use after controlling for physiological pain. Conclusions Sex, pain and anxiety and depression are inter-correlated and strong predictors of frequent OTCA use. Frequent OTCA use in the context of psychological distress may be a form of self-medication that can exacerbate symptoms and decrease psychosocial function. Longitudinal studies that explore causal trajectories between frequent on-label OTCA use and psychological distress are required. OTCA use among adolescents, and particularly among females, with anxiety and depression should be administered with caution and closely monitored.
format	article
author	Rune Jonassen Eva Hilland Catherine J. Harmer Dawit S. Abebe Anne Kristine Bergem Siv Skarstein
author_facet	Rune Jonassen Eva Hilland Catherine J. Harmer Dawit S. Abebe Anne Kristine Bergem Siv Skarstein
author_sort	Rune Jonassen
title	Over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway
title_short	Over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway
title_full	Over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway
title_fullStr	Over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway
title_full_unstemmed	Over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway
title_sort	over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from norway
publisher	BMC
publishDate	2021
url	https://doaj.org/article/f8d50d0fd3a54e4891f315c55ef1a844
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Over-the-counter analgesics use is associated with pain and psychological distress among adolescents: a mixed effects approach in cross-sectional survey data from Norway

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