Pain and Its Correlates Among Racially and Ethnically Diverse Adults with Serious Mental Illness

Background: Adults with serious mental illness are more likely than the general population to experience pain. However, the correlates of pain, and the role of demographic, behavioral, and psychosocial factors, are poorly understood.Methods: This one-year study included 489 respondents from several sites within a supportive housing agency spanning three New York City boroughs. Survey items included questions from several reliable and valid instruments measuring functional decline, frailty, loneliness, and other psychosocial factors.Results: Within the sample (n=489), 60.3% identified as male, 58.1% were Black, and the average age was 64.2 years old, with 60.3% diagnosed with schizophrenia and 57.1% experiencing pain. Demographic variables did not affect pain severity; however, frailty (Spearman’s rank correlation coefficient ρ = 0.49, p < 0.001), functional decline (ρ = -0.27, p < 0.001), and stress (ρ = 0.41, p < 0.001) were significantly associated with pain severity. Binary covariates within these domains, and adverse events (falls and hospitalizations), were also significantly associated with pain severity. While several psychosocial and medical factors were significant in univariate analyses, they were not significant predictors in a Tweedie regression model.Conclusions: Older adults with SMI are more likely than the general population to experience pain, which is mainly predicted by frailty, functional decline, and stress in this group. Integrated pain management models targeting this population should coordinate psychiatric care with addressing these factors.