ADHD (Attention-Deficit Hyperactivity Disorder) Symptoms Are Associated With Chronic Pain Interference: Results From a Prospective Cohort Study

Background

Despite a known relationship between attention-deficit hyperactivity disorder (ADHD) and chronic pain, the association between ADHD symptoms and pain interference has not been prospectively investigated.

Methods

Young adults were recruited following receipt of a prescription opioid from ambulatory surgery clinics, outpatient clinics and emergency departments as part of a larger study. Participants completed measures of ADHD symptoms, depression, pain catastrophizing, adverse childhood experiences and pain interference at enrolment and 6 months later. Logistic regression was used to examine the relationship between ADHD symptoms and covariates on moderate-to-severe pain interference at 6 months.

Results

Participants were 116 young adults who completed the baseline ADHD symptoms measure; 71 completed the 6-month timepoint. Moderate-to-severe pain interference was present among 89.7% at baseline and 52.3% at 6 months. ADHD symptoms (OR [odds ratio] = 1.42, 95% CI [confidence interval] = 1.05–1.93), depression (OR = 1.08, 95% CI = 1.02–1.14) and pain catastrophizing (OR = 1.06, 95% CI = 1.01–1.12) were significantly associated with odds of moderate-to-severe pain interference at 6 months. In multivariable regression, ADHD symptoms (OR = 1.52, 95% CI = 1.09–2.12) and pain catastrophizing (OR = 1.07, 95% CI = 1.01–1.13) were significant predictors of moderate-to-severe pain interference at 6 months.

Conclusions

Participants with more ADHD symptoms were at greater risk for chronic pain interference. This is consistent with prior studies examining the role of attention in chronic pain. Individuals with ADHD symptoms may be at greater risk for chronic pain and future research should investigate tailored prevention and treatment approaches.