Co-occurrence of chronic pain, depressive symptoms, and poor sleep quality in a health check-up population in China:A multicenter survey

Objectives This study aimed to investigate the cooccurrence of chronic pain (CP), depressive symptoms, and poor sleep quality in terms of prevalence and associated factors in a nationwide health check-up population in China. Methods This multicenter cross-sectional survey was performed in 2017. All the participants aged ≥18 years from eight health check-up institutions in 6 provinces and cities were invited to complete a self-report health questionnaire through online resources. Results 132,444 participants completed the online survey and the overall prevalence of CP and that of the three symptoms were 11.0% (95% confidence interval [95% CI]: 10.8–11.1) and 2.7% (95% CI: 2.6–2.8), respectively. The cooccurrence of all three symptoms increased with age, being higher in the female, widowed, unemployed, and lower education level groups. The respondents with multiple symptoms reported poorer self-rated health. Binary logistic regression analyses identified female sex (adjusted odds ratio [aOR]: 1.51; 95% CI: 1.42–1.62), a widowed status (aOR: 1.39; 95% CI: 1.04-1.84), a lower education level (aORs ranging from 1.46 to 2.47), and having one or more chronic diseases (aORs ranging from 1.43 to 2.02) to be significantly associated with reporting all three symptoms (all P ˂0.05). While long-term medication and regular exercise were the protective factors. Conclusion This study suggests that the cooccurrence of the three symptoms accounts for a certain proportion of the Chinese health check-up population. Integrated interventions that address CP and mental health cooccurrence may be an essential target for heath management in this population to tackle this considerable burden.