Open Access Open Badges Research article

A greater number of somatic pain sites is associated with poor mental health in adolescents: a cross-sectional study

Shuntaro Ando12, Syudo Yamasaki1, Shinji Shimodera3*, Tsukasa Sasaki4, Norihito Oshima4, Toshi A Furukawa5, Nozomu Asukai2, Kiyoto Kasai1, Yoshio Mino6, Shimpei Inoue3, Yuji Okazaki7 and Atsushi Nishida2

Author Affiliations

1 Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan

2 Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Kamikitazawa 2-1-6, Setagaya-ku, Tokyo 156-8506, Japan

3 Department of Neuropsychiatry, Kochi Medical School, Kohasu Oko-cho, Nankoku, Kochi 783-8505, Japan

4 Department of Health Education, Graduate School of Education and Office for Mental Health Support, The University of Tokyo, Tokyo, Japan

5 Department of Cognitive-Behavioral Medicine, Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan

6 Mino Clinic, 8F Urban Office Building, Shimo-ishii 1-1-1, Kita-ku, Okayama-shi, Okayama, 700-0907, Japan

7 Matsuzawa Hospital, Kamikitazawa 2-1-1, Setagaya-ku, Tokyo 156-0057, Japan

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BMC Psychiatry 2013, 13:30  doi:10.1186/1471-244X-13-30

Published: 17 January 2013



Identifying indicators of poor mental health during adolescence is a significant public health issue. Previous studies which suggested an association between the number of somatic pains and depression have mainly focused on adults or have employed samples with a narrow age range. To date, results from previous studies have been inconsistent regarding the association between somatic pain and academic impairment. Therefore, the main aims of the present study were to 1) investigate the association between the number of somatic pain sites and poor mental health using a community sample of adolescents aged 12 to 18 years and employing a simple method of assessment, and 2) examine the association between the number of somatic pain sites and perceived academic impairment.


Data analysis was conducted using a large cross-sectional survey of adolescents in grades 7 to 12. The one-month prevalence rates for three sites of somatic pain including head, neck and shoulders, and abdomen were examined. Poor mental health was evaluated using the General Health Questionnaire, and perceived academic impairment was measured using a self-report questionnaire.


A total of 18,104 adolescents participated in the survey. A greater number of pain sites was associated with poor mental health, and this association was consistent across age and gender. There was no difference in effect on mental health between any of the pain sites. Although there was an association between the number of somatic pain sites and perceived academic impairment, the results suggested that the association was mediated by poor mental health.


Simple reporting methods for assessing the number of pain sites may be a feasible indicator of poor mental health in adolescents. Professionals working with adolescents should consider the possibility of poor mental health, especially when students report multiple somatic pains.

Number; Somatic pain site; Poor mental health; Adolescents; Males and females; Academic impairment