Associations Between Lifetime Histories of Iron Deficiency, Anxiety, Depression and Multiple Pain Conditions: An Observational Study Using a Large-Scale National Database

David Champion,1,2 Minh Bui,3 Phillip Aouad,2,* Arthur Teng,1,4,* Arthur S Walters,5,* Elias Georges Karroum,6,* Aidan Christopher Tan,1,2,* Zijing Yang,7,* Emily Joyce,8,* Tiina Jaaniste1,2 1School of Clinical Medic...

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Main Authors: Champion D, Bui M, Aouad P, Teng A, Walters AS, Karroum EG, Tan AC, Yang Z, Joyce E, Jaaniste T
Format: Article
Language:English
Published: Dove Medical Press 2025-07-01
Series:Journal of Pain Research
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Online Access:https://www.dovepress.com/associations-between-lifetime-histories-of-iron-deficiency-anxiety-dep-peer-reviewed-fulltext-article-JPR
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author Champion D
Bui M
Aouad P
Teng A
Walters AS
Karroum EG
Tan AC
Yang Z
Joyce E
Jaaniste T
author_facet Champion D
Bui M
Aouad P
Teng A
Walters AS
Karroum EG
Tan AC
Yang Z
Joyce E
Jaaniste T
author_sort Champion D
collection DOAJ
description David Champion,1,2 Minh Bui,3 Phillip Aouad,2,* Arthur Teng,1,4,* Arthur S Walters,5,* Elias Georges Karroum,6,* Aidan Christopher Tan,1,2,* Zijing Yang,7,* Emily Joyce,8,* Tiina Jaaniste1,2 1School of Clinical Medicine, University of New South Wales, UNSW, Sydney, NSW, 2052, Australia; 2Department of Pain Medicine, Sydney Children`s Hospital, Randwick, NSW, 2031, Australia; 3Centre for Epidemiology and Biostatistics in the School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia; 4Department of Sleep Medicine, Sydney Children`s Hospital, Randwick, NSW, 2031, Australia; 5Department of Neurology, Sleep Division, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA; 6Department of Neurology, University of Virginia School of Medicine, Charlottesville, VA, 22903, USA; 7Department of Inflammation Biology, School of Immunology and Microbial Sciences, Centre for Rheumatic Diseases, King’s College, London Strand, London, WC2R 2LS, UK; 8Faculty of Science, University of Sydney, Sydney, NSW, 2006, Australia*These authors contributed equally to this workCorrespondence: David Champion, Department of Pain Medicine, Bright Alliance Building, Level 7, Sydney Children`s Hospital, Randwick, NSW, 2031, Australia, Tel +61 410405020, Email gdavidchampion@gmail.comPurpose: Our aims were to investigate in adults, as we have shown in three paediatric samples, associations between a history of iron deficiency (whenever acquired and treated) and history (> 3 months) of primary, overlapping and multisite chronic pain conditions, and to investigate associations between history of iron deficiency, anxiety, and depression.Participants and Methods: We recruited adult twins and their families from the Australian Twin Registry database. Responders addressed questionnaires about lifetime history of iron deficiency > 3 months, diagnosed and treated by a physician, and a history > 3 months of listed pain conditions, anxiety and depression. The emphasis was on life history, not current status, of each of these conditions and such questions were the only practical method. Logistic regression, using generalized estimating equation to account for correlations within twin families, was employed to assess relationships between iron deficiency and pain conditions and the psychological conditions.Results: Of the 1519 adult responders, 1326 addressed the criteria for iron deficiency, and the prevalence was 38.7% in females and 2.4% in males. Iron deficiency as statistical predictor was significantly associated with migraine (Odds ratio (OR)=1.70, p=0.001), headache (OR=1.37, p=0.03), recurrent abdominal pain (OR=1.97, p< 0.001), dysmenorrhea (OR=2.18, p< 0.001), anxiety (OR=1.88, p< 0.001) and depression (OR=2.06, p< 0.001). Iron deficiency, anxiety and depression, as statistical predictors, were univariately and multivariately associated with the number of pain conditions (all p< 0.05).Conclusion: A history of iron deficiency in a community sample of adults was associated with most individual, primary, overlapping and multisite pain conditions tested, and multivariately associated with the number of pain conditions, and with anxiety and depression. We hypothesize, consistent with these results, that previous or current iron deficiency, even when treated, influences pain sensitivity and multiplicity directly and through known effects on anxiety and depression.Keywords: iron deficiency, primary pain conditions, overlapping pain conditions, multisite pain conditions, anxiety, depression, twin family survey, association analyses
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spelling doaj-art-75c07e8dbdfb4c1799f7e24f78516be82025-08-20T03:58:36ZengDove Medical PressJournal of Pain Research1178-70902025-07-01Volume 18Issue 137813792105299Associations Between Lifetime Histories of Iron Deficiency, Anxiety, Depression and Multiple Pain Conditions: An Observational Study Using a Large-Scale National DatabaseChampion D0Bui M1Aouad P2Teng A3Walters AS4Karroum EG5Tan AC6Yang Z7Joyce E8Jaaniste T9Pain MedicineCentre for Epidemiology and Biostatistics in the School of Population and Global HealthPsychological MedicineDepartment of Sleep MedicineVanderbilt University School of Medicine, Department of NeurologyDepartment of NeurologySydney School of Public HealthDepartment of Inflammation Biology,Faculty of SciencePain and Palliative CareDavid Champion,1,2 Minh Bui,3 Phillip Aouad,2,* Arthur Teng,1,4,* Arthur S Walters,5,* Elias Georges Karroum,6,* Aidan Christopher Tan,1,2,* Zijing Yang,7,* Emily Joyce,8,* Tiina Jaaniste1,2 1School of Clinical Medicine, University of New South Wales, UNSW, Sydney, NSW, 2052, Australia; 2Department of Pain Medicine, Sydney Children`s Hospital, Randwick, NSW, 2031, Australia; 3Centre for Epidemiology and Biostatistics in the School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia; 4Department of Sleep Medicine, Sydney Children`s Hospital, Randwick, NSW, 2031, Australia; 5Department of Neurology, Sleep Division, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA; 6Department of Neurology, University of Virginia School of Medicine, Charlottesville, VA, 22903, USA; 7Department of Inflammation Biology, School of Immunology and Microbial Sciences, Centre for Rheumatic Diseases, King’s College, London Strand, London, WC2R 2LS, UK; 8Faculty of Science, University of Sydney, Sydney, NSW, 2006, Australia*These authors contributed equally to this workCorrespondence: David Champion, Department of Pain Medicine, Bright Alliance Building, Level 7, Sydney Children`s Hospital, Randwick, NSW, 2031, Australia, Tel +61 410405020, Email gdavidchampion@gmail.comPurpose: Our aims were to investigate in adults, as we have shown in three paediatric samples, associations between a history of iron deficiency (whenever acquired and treated) and history (> 3 months) of primary, overlapping and multisite chronic pain conditions, and to investigate associations between history of iron deficiency, anxiety, and depression.Participants and Methods: We recruited adult twins and their families from the Australian Twin Registry database. Responders addressed questionnaires about lifetime history of iron deficiency > 3 months, diagnosed and treated by a physician, and a history > 3 months of listed pain conditions, anxiety and depression. The emphasis was on life history, not current status, of each of these conditions and such questions were the only practical method. Logistic regression, using generalized estimating equation to account for correlations within twin families, was employed to assess relationships between iron deficiency and pain conditions and the psychological conditions.Results: Of the 1519 adult responders, 1326 addressed the criteria for iron deficiency, and the prevalence was 38.7% in females and 2.4% in males. Iron deficiency as statistical predictor was significantly associated with migraine (Odds ratio (OR)=1.70, p=0.001), headache (OR=1.37, p=0.03), recurrent abdominal pain (OR=1.97, p< 0.001), dysmenorrhea (OR=2.18, p< 0.001), anxiety (OR=1.88, p< 0.001) and depression (OR=2.06, p< 0.001). Iron deficiency, anxiety and depression, as statistical predictors, were univariately and multivariately associated with the number of pain conditions (all p< 0.05).Conclusion: A history of iron deficiency in a community sample of adults was associated with most individual, primary, overlapping and multisite pain conditions tested, and multivariately associated with the number of pain conditions, and with anxiety and depression. We hypothesize, consistent with these results, that previous or current iron deficiency, even when treated, influences pain sensitivity and multiplicity directly and through known effects on anxiety and depression.Keywords: iron deficiency, primary pain conditions, overlapping pain conditions, multisite pain conditions, anxiety, depression, twin family survey, association analyseshttps://www.dovepress.com/associations-between-lifetime-histories-of-iron-deficiency-anxiety-dep-peer-reviewed-fulltext-article-JPRiron deficiencyprimary pain conditionsoverlapping pain conditionsmultisite pain conditionsanxietydepression
spellingShingle Champion D
Bui M
Aouad P
Teng A
Walters AS
Karroum EG
Tan AC
Yang Z
Joyce E
Jaaniste T
Associations Between Lifetime Histories of Iron Deficiency, Anxiety, Depression and Multiple Pain Conditions: An Observational Study Using a Large-Scale National Database
Journal of Pain Research
iron deficiency
primary pain conditions
overlapping pain conditions
multisite pain conditions
anxiety
depression
title Associations Between Lifetime Histories of Iron Deficiency, Anxiety, Depression and Multiple Pain Conditions: An Observational Study Using a Large-Scale National Database
title_full Associations Between Lifetime Histories of Iron Deficiency, Anxiety, Depression and Multiple Pain Conditions: An Observational Study Using a Large-Scale National Database
title_fullStr Associations Between Lifetime Histories of Iron Deficiency, Anxiety, Depression and Multiple Pain Conditions: An Observational Study Using a Large-Scale National Database
title_full_unstemmed Associations Between Lifetime Histories of Iron Deficiency, Anxiety, Depression and Multiple Pain Conditions: An Observational Study Using a Large-Scale National Database
title_short Associations Between Lifetime Histories of Iron Deficiency, Anxiety, Depression and Multiple Pain Conditions: An Observational Study Using a Large-Scale National Database
title_sort associations between lifetime histories of iron deficiency anxiety depression and multiple pain conditions an observational study using a large scale national database
topic iron deficiency
primary pain conditions
overlapping pain conditions
multisite pain conditions
anxiety
depression
url https://www.dovepress.com/associations-between-lifetime-histories-of-iron-deficiency-anxiety-dep-peer-reviewed-fulltext-article-JPR
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