Frequent physical pain during childhood is linked to an increased risk of suicidal thoughts and attempts in adolescence

A new national study shows that children who frequently experience pain, such as headaches, stomachaches, back pain, or neck pain, have an elevated risk of developing suicidal thoughts and attempting suicide during their teenage years. This is especially true if the pain occurs weekly, disrupts sleep, or limits daily school and sports activities.

The study is based on data from more than 28,000 children in the Danish birth cohort ‘Better Health in Generations’. At age 11, participants reported whether they experienced pain in the head, stomach, back, or neck. At age 18, they were asked about their experiences with suicidal thoughts and suicide attempts, and information was also retrieved from Danish hospital registers on recorded suicide attempts.

In the study population, 13.5% experienced frequent pain at age 11. Among these, 42% had suicidal thoughts and 6.5% had attempted suicide before turning 18. By comparison, the numbers were lower among children without frequent pain, i.e. around 30% and 3%, respectively. Although most children who experience frequent pain do not attempt suicide or develop suicidal thoughts, it is important to be attentive to children who experience frequent pain.

“Our research shows a clear link between frequent pain in childhood and an increased risk of suicidal thoughts and attempts in adolescence. This is an important insight, which should make health professionals, teachers, and parents extra attentive when children repeatedly complain about pain – because it may signal more than just physical problems,” says Liv Mathilde Pampiri, lead author and research student at the Danish Research Institute for Suicide Prevention (DRISP).

She is supported by Trine Madsen, PhD, Associate Professor and Senior Researcher at DRISP: “Our findings highlight the importance of a holistic approach to children who experience frequent pain. An approach where physical pain and psychological support are considered together, especially since pain often occurs alongside psychological distress. However, it should be emphasized that not all children with pain experience psychological problems. Each case should therefore be assessed individually,” says Trine Madsen.

Part of the link between pain and suicidal behavior can be explained by mental disorders such as anxiety and depression. The analysis shows that these diagnoses account for about 15% of the association with suicidal thoughts – and up to 50% of the association with suicide attempts. This suggests that many children with frequent pain may have suicidal thoughts without having been diagnosed with a mental disorder, whereas suicide attempts are much more common among children and adolescents already struggling with mental illness. It is important to stress that the connection between pain, psychological distress, and suicidal behavior is not straightforward. Regardless of which comes first, the findings show that children with frequent pain have an increased risk of both suicidal thoughts and suicide attempts.