Association of painful musculoskeletal conditions and migraine headache with mental and sleep disorders among adults with disabilities, Spain, 2007-2008.

Introduction: The aim of this study was to determine the prevalence of painful musculoskeletal conditions and migraine headache or any other headache in a sample of Spanish adults with disabilities and their association with anxiety, depression, and sleep disorders.

Methods: This cross-sectional study analyzed data from the Spanish national disability and dependence survey (2007-2008) of 16,932 adults aged 18 or older who have disabilities. The prevalence (95% confidence interval [CI]) of painful musculoskeletal conditions was determined according to a diagnosis of arthritis, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, muscular dystrophy, and neck or back pain. The prevalence of migraine or other headache was also calculated. Factors associated with these painful conditions were analyzed separately for men and women by using a logistic regression model.

Results: The prevalence of painful musculoskeletal conditions was 66.9% (95% CI, 66.2%-67.6%) and that of migraine or other headache was 23.4% (95% CI, 22.8%-24.1%), both of which were higher in women than in men. Factors associated with these conditions in both men and women included older age, a sleep disorder, and concomitant chronic anxiety and/or depression.

Conclusion: The prevalence of painful musculoskeletal conditions and migraine or other headache is high in people with disability in Spain, especially in women, and these conditions often coexist with depression, anxiety, and/or a sleep disorder. To design programs for rehabilitating and improving the quality of life of adults with disability and painful conditions, treatments for mental and/or sleep disorders should be considered in addition to conventional treatments.