Abstract

Warning View the most recent version.

Archived Content

Information identified as archived is provided for reference, research or recordkeeping purposes. It is not subject to the Government of Canada Web Standards and has not been altered or updated since it was archived. Please "contact us" to request a format other than those available.

Skip to text

Background
Keywords
Findings
Author
What is already known on this subject?
What does this study add?

Text begins

Background

According to the activity restriction (AR) model, a potential explanation for the impact of chronic pain on mental illness is that pain contributes to depression by limiting usual activities. This study uses a measure of mental health (flourishing), rather than mental illness to examine associations between pain and activity restrictions.

Data and methods

Data from the 2011/2012 Canadian Community Health Survey were used to study the relationship between pain intensity, pain-related activity prevention, and flourishing mental health in people aged 18 or older. Multivariate logistic regression was used in a sample of 26,429 people with chronic pain to identify significant relationships, while adjusting for potential confounders.

Results

In 2011/2012, an estimated 6 million Canadians aged 18 or older (22%) reported chronic pain. They were less likely to be in flourishing mental health than were people without chronic pain (69% versus 79%). The prevalence of flourishing mental health declined as pain intensity and the number of activities prevented because of pain increased. Pain intensity and pain-related activity prevention were each independently associated with flourishing mental health, even when socio-demographic and health factors were taken into account. Pain-related activity prevention partially mediated the association between pain intensity and flourishing mental health.

Interpretation

The results of this study support the AR model and highlight the importance of both pain intensity and activity restriction in relation to flourishing mental health.

Keywords

Positive Mental Health Continuum – Short Form (MHC-SF), cross-sectional study, health survey

Findings

The association between chronic pain and poor psychological health is well established. A potential explanation for this relationship is that pain affects mental well-being by limiting usual activities such as personal care, work and family roles and leisure and social pursuits. The Activity Restriction (AR) model of depressed affect posits that psychological adjustment to a stressor is related largely, and sometimes only, to the day-to-day activity restrictions that result. Thus, while pain can contribute directly to mental illness, it can also contribute indirectly by limiting activities and thereby increasing psychological distress. In the AR model, activity restriction mediates the relationship between pain and depression. [Full Text]

Author

Heather Gilmour (Heather.Gilmour@statcan.gc.ca) is with the Health Analysis Division at Statistics Canada, Ottawa, Ontario.

What is already known on this subject?

  • Results of previous research on the role of activity restriction as a mediator in the relationship between pain and mental illness have been inconclusive.
  • Many studies were based on small samples, examined specific subpopulations, and assessed mental illness with measures of depression.
  • A longitudinal study found flourishing mental health to be protective of all-cause mortality.

What does this study adds?

  • The relationship between pain, prevention of activities, and mental health rather than mental illness was assessed.
  • More than 6 million adults (22%) reported chronic pain in 2011/2012.
  • Those in chronic pain were less likely to be in flourishing mental health (69% versus 79%).
  • Even when socio-demographic and health characteristics were taken into account, those with moderate or severe pain intensity had lower odds of flourishing mental health than did those with mild pain.
  • Activity restriction was independently associated with flourishing mental health, and mediated the association between pain intensity and flourishing mental health, supporting  the Activity Restriction (AR) model.
  • Differences in the AR model by age group and sex were not apparent.
Report a problem on this page

Is something not working? Is there information outdated? Can't find what you're looking for?

Please contact us and let us know how we can help you.

Privacy notice

Date modified: