{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:56:23Z","timestamp":1790632583464,"version":"4.1.0"},"reference-count":75,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T00:00:00Z","timestamp":1606694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Health Mission"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Objectives<\/jats:title><jats:p>The study examined the prevalence, sociodemographic, and clinical correlates of chronic pain among primary care patients in the state of Kerala, India. It also examined the patterns and relationships of chronic physical and mental health conditions with chronic pain.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>This study is a cross-sectional survey conducted among 7165 adult patients selected randomly by a multi-stage stratified design from 71 primary health centers. The questionnaires administered included Chronic pain screening questionnaire, self-reported Chronic physical health condition checklist, Patient Health Questionnaire-SADS, The Alcohol Use Disorders Identification Test, Fagerstr\u00f6m Test for Nicotine Dependence, WHO Disability Assessment Schedule and WHOQOL- BREF for Quality\/Satisfaction with Life. The prevalence and comorbid patterns of chronic pain were determined. Logistic regression analysis and generalized linear mixed-effects model was employed to examine the relationship of chronic pain to socio-demographic variables and examined physical and mental health conditions.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>A total of 1831 (27%) patients reported chronic pain. Among those with chronic pain, 28.3% reported no co-occurring chronic mental or physical illness, 35.3% reported one, and 36.3% reported multi-morbidity. In the multivariate analysis, patients with chronic pain when compared to those without had higher odds of being older, female, having lower education, not living with their family, greater disability, and poor satisfaction with life. Chronic pain was independently associated with both medical (hypertension, diabetes mellitus, tuberculosis, arthritis, and other medical illnesses) and mental health conditions (depressive disorders, anxiety disorders, and tobacco dependence). It showed a varying strength of association and additive effect with increasing number of co-occurring physical and mental illnesses.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Chronic pain is a common condition among primary care attendees associated with significant burden of medical and mental health comorbidity. The findings highlight the need to incorporate treatment models that will ensure appropriate management to improve outcomes within the resource constraints.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0242865","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T18:48:44Z","timestamp":1606762124000},"page":"e0242865","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":25,"title":["Disentangling comorbidity in chronic pain: A study in primary health care settings from India"],"prefix":"10.1371","volume":"15","author":[{"given":"Geetha","family":"Desai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0322-9209","authenticated-orcid":true,"given":"Jaisoorya","family":"T. S.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil Kumar","family":"G.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"L.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokul","family":"G. R.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aakash","family":"Bajaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thennarasu","family":"K.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh K.","family":"Chaturvedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,11,30]]},"reference":[{"key":"pone.0242865.ref001","author":"H Merskey","year":"1994"},{"key":"pone.0242865.ref002","first-page":"17","volume-title":"Bonica\u2019s Management of Pain","author":"A Okifuji","year":"2001"},{"key":"pone.0242865.ref003","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.jpain.2008.05.005","article-title":"Common Chronic Pain Conditions in Developed and Developing Countries: Gender and Age Differences and Comorbidity With Depression-Anxiety Disorders","volume":"9","author":"A Tsang","year":"2008","journal-title":"J Pain"},{"key":"pone.0242865.ref004","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1001\/jama.280.2.147","article-title":"Persistent pain and well-being: a World Health Organization study in primary care","volume":"280","author":"O Gureje","year":"1998","journal-title":"JAMA"},{"key":"pone.0242865.ref005","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/S0304-3959(98)00117-1","article-title":"Prevalence of chronic benign pain disorder among adults: A review of the literature","volume":"77","author":"PFM Verhaak","year":"1998","journal-title":"Pain"},{"key":"pone.0242865.ref006","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.ejpain.2005.06.009","article-title":"Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment","volume":"10","author":"H Breivik","year":"2006","journal-title":"Eur J Pain"},{"key":"pone.0242865.ref007","doi-asserted-by":"crossref","first-page":"e010364","DOI":"10.1136\/bmjopen-2015-010364","article-title":"Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies","author":"A Fayaz","year":"2016","journal-title":"BMJ Open"},{"key":"pone.0242865.ref008","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1016\/j.jpain.2010.07.002","article-title":"The Prevalence of Chronic Pain in United States Adults: Results of an Internet-Based Survey","volume":"11","author":"CB Johannes","year":"2010","journal-title":"J Pain"},{"issue":"11","key":"pone.0242865.ref009","doi-asserted-by":"crossref","first-page":"937","DOI":"10.47102\/annals-acadmedsg.V38N11p937","article-title":"Pain prevalence in Singapore","volume":"38","author":"SN Yeo","year":"2009","journal-title":"Ann Acad Med Singapore"},{"issue":"2","key":"pone.0242865.ref010","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/0304-3959(87)91039-6","article-title":"Prevalence of chronic pain in psychiatric patients","volume":"29","author":"SK Chaturvedi","year":"1987","journal-title":"Pain"},{"key":"pone.0242865.ref011","doi-asserted-by":"crossref","first-page":"E51","DOI":"10.1111\/papr.12132","article-title":"Prevalence of Chronic Pain, Impact on Daily Life, and Treatment Practices in India","volume":"14","author":"GP Dureja","year":"2014","journal-title":"Pain Pract"},{"key":"pone.0242865.ref012","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4103\/ijpn.ijpn_32_18","article-title":"Prevalence of chronic pain based on primary health center data from a city in central India","volume":"32","author":"A Deshpande","year":"2018","journal-title":"Indian J Pain"},{"key":"pone.0242865.ref013","doi-asserted-by":"crossref","first-page":"472","DOI":"10.4103\/IJPC.IJPC_141_18","article-title":"The prevalence of chronic pain among adults in India","volume":"24","author":"AK Saxena","year":"2018","journal-title":"Indian J Palliat Care"},{"key":"pone.0242865.ref014","doi-asserted-by":"crossref","first-page":"e273","DOI":"10.1016\/j.bja.2019.03.023","article-title":"Chronic pain: a review of its epidemiology and associated factors in population-based studies","volume":"123","author":"SE Mills","year":"2019","journal-title":"Br J Anaesthesia"},{"key":"pone.0242865.ref015","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S0277-9536(01)00018-1","article-title":"Severity of musculoskeletal pain: Relations to socioeconomic inequality","volume":"54","author":"M Brekke","year":"2002","journal-title":"Soc Sci Med"},{"key":"pone.0242865.ref016","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/bja\/aet123","article-title":"Chronic pain epidemiology and its clinical relevance","volume":"111","author":"O van Hecke","year":"2013","journal-title":"Br J Anaesth"},{"key":"pone.0242865.ref017","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1097\/j.pain.0000000000001311","article-title":"Global burden of pain and global pain policy\u2014creating a purposeful body of evidence","volume":"159","author":"FM Blyth","year":"2018","journal-title":"Pain"},{"key":"pone.0242865.ref018","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.pain.2008.04.003","article-title":"Socioeconomic disadvantage and pain","volume":"136","author":"EL Poleshuck","year":"2008","journal-title":"Pain"},{"key":"pone.0242865.ref019","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/1471-2296-12-16","article-title":"Revisiting the symptom iceberg in today\u2019s primary care: 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A systematic review and meta-analysis of mediation studies in people with back and neck pain","volume":"156","author":"H Lee","year":"2015","journal-title":"Pain"},{"key":"pone.0242865.ref023","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/bjc.12078","article-title":"Psychological functioning of people living with chronic pain: A meta\u2010analytic review","volume":"54","author":"AL Burke","year":"2015","journal-title":"Br J Clin Psychol"},{"key":"pone.0242865.ref024","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/AJP.0000000000000260","article-title":"A critical review of neurobiological factors involved in the interactions between chronic pain, depression, and sleep disruption","volume":"32","author":"PA Boakye","year":"2016","journal-title":"Clin J Pain"},{"key":"pone.0242865.ref025","unstructured":"World Health Organization. ICD 11. [cited 2020 Jan 7]. Available from: https:\/\/www.who.int\/classifications\/icd\/revision\/en\/"},{"key":"pone.0242865.ref026","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/SPC.0b013e328345a3ec","article-title":"Management of chronic pain in primary care","volume":"5","author":"BH Smith","year":"2011","journal-title":"Curr Opin Support Palliat Care"},{"key":"pone.0242865.ref027","doi-asserted-by":"crossref","first-page":"e297","DOI":"10.3399\/bjgp12X636146","article-title":"Multimorbidity in primary care: a systematic review of prospective cohort studies","volume":"62","author":"EF France","year":"2012","journal-title":"Br J Gen Pract"},{"key":"pone.0242865.ref028","doi-asserted-by":"crossref","first-page":"e017902","DOI":"10.1136\/bmjopen-2017-017902","article-title":"International variations in primary care physician consultation time: A systematic review of 67 countries","volume":"7","author":"G Irving","year":"2017","journal-title":"BMJ Open"},{"key":"pone.0242865.ref029","doi-asserted-by":"crossref","first-page":"e776","DOI":"10.1016\/S2214-109X(15)00152-7","article-title":"Symptoms and medical conditions in 204 912 patients visiting primary health-care practitioners in India: a 1-day point prevalence study (the POSEIDON study)","volume":"3","author":"S Salvi","year":"2015","journal-title":"Lancet Glob Health"},{"key":"pone.0242865.ref030","first-page":"307","article-title":"Patel V: The epidemiology of Common Mental Disorders in South Asia","volume":"17","year":"1999","journal-title":"NIMHANS Jnl"},{"key":"pone.0242865.ref031","first-page":"0020764020907941","article-title":"The National Mental Health Survey of India (2016): Prevalence, socio-demographic correlates and treatment gap of mental morbidity","author":"MS Gautham","year":"2020","journal-title":"Int J Soc Psychiatry"},{"key":"pone.0242865.ref032","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.genhosppsych.2010.03.006","article-title":"The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: A systematic review","volume":"32","author":"K Kroenke","year":"2010","journal-title":"Gen Hosp Psychiatry"},{"key":"pone.0242865.ref033","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1177\/070674371506000402","article-title":"Chronic Pain, Psychopathology, and DSM-5 Somatic Symptom Disorder","volume":"60","author":"J Katz","year":"2015","journal-title":"Can J Psychiatry"},{"key":"pone.0242865.ref034","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/j.1360-0443.1993.tb02093.x","article-title":"Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II","volume":"88","author":"JB Saunders","year":"1993","journal-title":"Addiction"},{"key":"pone.0242865.ref035","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1111\/j.1360-0443.1991.tb01879.x","article-title":"The Fagerstr\u00f6m test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire","volume":"86","author":"TF Heatherton","year":"1991","journal-title":"Br J Addcit"},{"key":"pone.0242865.ref036","doi-asserted-by":"crossref","first-page":"815","DOI":"10.2471\/BLT.09.067231","article-title":"Developing the World Health Organization disability assessment schedule 2.0","volume":"88","author":"T \u00dcst\u00fcn","year":"2010","journal-title":"Bull World Health Organ"},{"key":"pone.0242865.ref037","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1017\/S0033291798006667","article-title":"Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment","volume":"28","author":"A Harper","year":"1998","journal-title":"Psychol Med"},{"issue":"6","key":"pone.0242865.ref038","article-title":"Prevalence of chronic pain in developing countries: systematic review and meta-analysis","volume":"4","author":"KN S\u00e1","year":"2019","journal-title":"Pain Reports"},{"issue":"1","key":"pone.0242865.ref039","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1186\/1471-2458-9-299","article-title":"Chronic pain in primary care. German figures from 1991 and 2006","volume":"9","author":"CH Frie\u00dfem","year":"2009","journal-title":"BMC Public Health"},{"key":"pone.0242865.ref040","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.anclin.2015.05.011","article-title":"Chronic Pain in Older Adults","author":"MC Bucket","year":"2015","journal-title":"Anesthesiol Clinic"},{"key":"pone.0242865.ref041","doi-asserted-by":"crossref","first-page":"S26","DOI":"10.1016\/j.pain.2007.10.014","article-title":"Studying sex and gender differences in pain and analgesia: A consensus report","volume":"132","author":"JD Greenspan","year":"2007","journal-title":"Pain"},{"key":"pone.0242865.ref042","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.pain.2007.09.028","article-title":"Modulation of pain by estrogens","volume":"132","author":"RM Craft","year":"2007","journal-title":"Pain"},{"key":"pone.0242865.ref043","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1155\/2015\/490610","article-title":"Associations among gender, coping patterns and functioning for individuals with chronic pain: a systematic review","volume":"20","author":"N El-Shormilisy","year":"2015","journal-title":"Pain Res Manag"},{"key":"pone.0242865.ref044","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1016\/j.ebiom.2015.08.001","article-title":"Wellcome Trust Case Control Consortium 2 (WTCCC2. A genome-wide association study provides evidence of sex-specific involvement of Chr1p35. 1 (ZSCAN20-TLR12P) and Chr8p23. 1 (HMGB1P46) with diabetic neuropathic pain","volume":"2","author":"W Meng","year":"2015","journal-title":"EBioMedicine"},{"key":"pone.0242865.ref045","doi-asserted-by":"crossref","first-page":"652e66","DOI":"10.1016\/j.pain.2008.02.030","article-title":"Social risks for disabling pain in older people: a prospective study of individual and area characteristics","volume":"137","author":"K Jordan","year":"2008","journal-title":"Pain"},{"key":"pone.0242865.ref046","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1037\/a0034012","article-title":"Pain, depression, and fatigue: loneliness as a longitudinal risk factor","volume":"33","author":"LM Jaremka","year":"2014","journal-title":"Health Psychol"},{"key":"pone.0242865.ref047","first-page":"325","article-title":"Prevalence and physical-mental comorbidity of chronic back and neck pain in Spain: results from the ESEMeD Study","volume":"127","author":"A Pinto-Meza","year":"2006","journal-title":"Medicina clinica"},{"key":"pone.0242865.ref048","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.jpsychires.2012.01.001","article-title":"Prevalence and comorbidity of chronic pain in the German general population","volume":"46","author":"MM Ohayon","year":"2012","journal-title":"Journal of psychiatric research"},{"key":"pone.0242865.ref049","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jad.2019.08.089","article-title":"The comorbidity of mental and physical disorders with self-reported chronic back or neck pain: Results from the China Mental Health Survey","volume":"260","author":"Y Xu","journal-title":"J Affect Disord"},{"key":"pone.0242865.ref050","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.arr.2011.03.003","article-title":"Aging with multimorbidity: a systematic review of the literature","volume":"10","author":"A Marengoni","year":"2011","journal-title":"Ageing Res Rev"},{"issue":"1","key":"pone.0242865.ref051","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12875-016-0468-1","article-title":"Association between multimorbidity patterns and chronic pain in elderly primary care patients: a cross-sectional observational study","volume":"17","author":"M Scherer","year":"2016","journal-title":"BMC family practice"},{"issue":"suppl 3","key":"pone.0242865.ref052","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/ar805","article-title":"Assessing the burden of musculoskeletal conditions: a joint World Health Organization-bone and joint decade project","volume":"5","author":"N Khaltaev","year":"2003","journal-title":"Arthritis Res Ther"},{"issue":"2","key":"pone.0242865.ref053","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/ar3306","article-title":"The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgia","volume":"13","author":"YC Lee","year":"2011","journal-title":"Arthritis research & therapy"},{"issue":"3","key":"pone.0242865.ref054","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.TPM.0000717700.03590.b6","article-title":"Underlying Mechanisms and Advances in Management of Chronic Pain in Diabetes Mellitus","volume":"36","author":"J Kilcoyne","year":"2020","journal-title":"Topics in Pain Management"},{"issue":"2","key":"pone.0242865.ref055","doi-asserted-by":"crossref","first-page":"e0212030","DOI":"10.1371\/journal.pone.0212030","article-title":"Is there an association between diabetes and neck and back pain? 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study","volume":"7","author":"N Gupta","year":"2018","journal-title":"Fam Med Prim Care Rev"},{"issue":"1","key":"pone.0242865.ref059","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3109\/02770903.2010.520229","article-title":"Musculoskeletal dysfunction and pain in adults with asthma","volume":"48","author":"AC Lunardi","year":"2011","journal-title":"Journal of asthma"},{"issue":"2","key":"pone.0242865.ref060","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s12016-012-8302-6","article-title":"Psoriatic arthritis: a critical review","volume":"44","author":"V Dhir","year":"2013","journal-title":"Clin Rev Allergy Immunol"},{"issue":"2","key":"pone.0242865.ref061","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1111\/j.1528-1167.2010.02927.x","article-title":"Comorbidities of epilepsy: results from the Epilepsy Comorbidities and Health (EPIC) survey","volume":"52","author":"R Ottman","year":"2011","journal-title":"Epilepsia"},{"key":"pone.0242865.ref062","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S0304-3959(03)00225-2","article-title":"Epidemiology of chronic non-malignant pain in Denmark","volume":"106","author":"J Eriksen","year":"2003","journal-title":"Pain"},{"key":"pone.0242865.ref063","doi-asserted-by":"crossref","first-page":"407","DOI":"10.3109\/10673220903463226","article-title":"Comorbid pain, depression, and anxiety: Multifaceted pathology allows for multifaceted treatment","volume":"17","author":"SE Nicolson","year":"2009","journal-title":"Harv Rev Psychiatry"},{"key":"pone.0242865.ref064","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.ejpain.2011.05.007","article-title":"Self\u2010criticism interacts with the affective component of pain to predict depressive symptoms in female patients","volume":"16","author":"SF Lerman","year":"2012","journal-title":"Euro f 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