Relação entre perfis de estilo de vida e coocorrência de dor e sintomas depressivos em universitários brasileiros: Consórcio UNILIFE-M

Abstract

Pain and depression have a strong relationship. In people with pain, the prevalence of depression can reach 85%. And about 65% of people with depression report pain. This could occur because the presence of one of these conditions may trigger adaptations in the Central Nervous System that facilitate the occurrence of the other condition. The co-occurrence of pain and depression can result in a worse prognosis for both conditions, as well as greater disability, creating a cycle between these conditions. Research has focused on understanding modifiable factors, such as lifestyle behaviors, both for prevention and treatment of pain and depression, but this area remains underexplored. Therefore, the objectives of this study were: I) to describe lifestyle profiles (clusters), and II) to investigate associations between lifestyle profiles and the co-occurrence of pain and depressive symptoms in Brazilian university students. A cross sectional analysis was conducted using baseline data from the study "Trajectories of Lifestyle and Mental Health of University Students: The Prospective Cohort (UNILIFE-M)," with 11,069 responses. The study population consisted of Brazilian university students, freshmen in 2023 and 2024, aged between 16 and 35 years. Data on lifestyle, co-occurrence of pain and depressive symptoms, and additional measures were collected through an online survey. The domains (nutrition, use of psychoactive substances, physical activity, stress management, social relationships, sleep, and environmental exposure) of the University Short Multidimensional Inventory Lifestyle Evaluation (U-SMILE) were used to form lifestyle profiles, through cluster analysis. Co-occurrence was characterized by the presence of pain and depressive symptoms, where pain was identified by the self-report of chronic low back pain, chronic neck pain, or migraine, and depressive symptoms by a score ≥10 on the Patient Health Questionnaire-9 (PHQ-9). A multinomial logistic regression model, adjusted for age, gender, and social class, was created to evaluate the relationship between cluster variables and co-occurrence. A total of 6,371 participants were included, forming 3 clusters: Mostly-negative, Mostly-positive, and Substance-abuse, representing 44%, 42%, and 14%, respectively, of the participants. Belonging to the Mostly-negative and Substance-abuse clusters was positively associated with co occurrence. The odds of experiencing co-occurrence were 2.78 (95%CI: 2.11-3.68, p<0.001) and 4.19 (95%CI: 2.90-6.05, p<0.001) times higher in the Mostly-negative and Substance abuse clusters, respectively, compared to the Mostly-positive cluster. This study provides innovative information on lifestyle profiles and their relationship with co-occurrence of pain and depression, identifying that university students with less healthy lifestyle profiles have higher chances of experiencing co-occurrence of pain and depressive symptoms. This study highlights the importance of further research exploring the relationship between lifestyle and the co-occurrence of pain and depression, which may help define targets for behavioral changes aimed at reducing the consequences of these conditions in this population, facilitating the professional formation and personal development of university students.