Objective: Although several studies have shown that adolescent musculoskeletal pain is associated with psychological problems in a cross-sectional setting, the associations of long-term musculoskeletal pain with psychological distress and anxiety are not known.

Methods: The study included 1773 adolescents belonging to the Northern Finland Birth Cohort 1986. They received a postal questionnaire at the age of 16 years and a follow-up questionnaire two years later. The first inquiry contained questions about the sites of musculoskeletal pain; the second had the same pain questions, along with measures of distress and anxiety. Risk ratios (RR) were assessed by log-linear regression analysis.

Results: Multi-site musculoskeletal pain (in >=.2 body locations) at both 16 and 18 years was common, reported by 53% of girls and 30% of boys. Multi-site pain at both ages, compared to those with multi-site pain neither at 16 nor 18 years, was associated with psychological distress at the age of 18 among both girls (RR 1.8 95% Cl 12-2.7) and boys (RR 3.5 95% Cl 2.1-5.9). For anxiety, the corresponding relative risks were 1.5 (95% Cl 1.0-2.2) and 1.8 (95% Cl 1.4-23), respectively. For short-term multi-site pain (prevalent only at the age of 16 or 18), these relative risks were between 0.8 and 23.

Conclusions: Adolescents with long-term multi-site pain have higher levels of distress and anxiety than those without or with only short-term multi-site pain. Associations were found in both genders, but the relationship between pain and distress was more pronounced among boys. The associations had modest effect strength. (C) 2016 Elsevier Inc. All rights reserved.