Exploring the comorbidity between personality and musculoskeletal disorders among adults: A scoping review

Shae E Quirk; Heli Koivumaa-Honkanen; Bianca E Kavanagh; Risto J Honkanen; Jeremi Heikkinen; Lana J Williams

doi:10.3389/fpsyt.2022.1079106

Exploring the comorbidity between personality and musculoskeletal disorders among adults: A scoping review

Front Psychiatry. 2023 Feb 2:13:1079106. doi: 10.3389/fpsyt.2022.1079106. eCollection 2022.

Authors

Shae E Quirk^{1

2

3}, Heli Koivumaa-Honkanen^{2

3

4}, Bianca E Kavanagh¹, Risto J Honkanen^{2

3}, Jeremi Heikkinen^{2

3}, Lana J Williams^{1

5}

Affiliations

¹ School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia.
² Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland.
³ Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
⁴ Mental Health and Wellbeing Center, Kuopio University Hospital, Kuopio, Finland.
⁵ Barwon Health, University Hospital Geelong, Geelong, VIC, Australia.

Abstract

Introduction: There is growing awareness of the comorbidity between mental and musculoskeletal disorders (MSDs) and their associated burden. We aimed to explore what is known regarding the existing epidemiological clinical-and population- based literature on the comorbidity between personality disorders (PDs) and MSDs specifically. In addition, we aimed to investigate their associated burden by examining a range of outcomes including morbidity/mortality, patient- and clinical-reported outcomes, work-related outcomes, hospital admissions, and financial costs. Finally, we sought to identify gaps in the literature and provide recommendations for further research.

Methods: Studies with participants 15 years of age were eligible. Categorical PDs/features (DSM-III/IV/5 or ICD 9/10), identified by a health care professional, medical records, diagnostic interviews, or self-administered questionnaires. The definitions/groupings of MSDs were guided by the ICD-10 including conditions of the back, joints, and soft tissue, and disorders of bone density and structure. Published peer-reviewed and gray literature were considered. Eligible study designs were cohort, case-control, and cross-sectional studies, and existing reviews of observational studies. Identification and selection of articles, data extraction and the presentation of the results was conducted according to the Joanna Briggs Institute methodological guidance and the PRISMA extension for scoping reviews.

Results: In total, 57 articles were eligible including 10 reviews and 47 individual studies. Across clinical and population settings, we detected evidence of comorbidity between PDs and chronic back/neck/spine conditions, arthritis, and fibromyalgia, and emerging evidence of associations between PDs and reduced bone mineral density. In terms of knowledge gaps, the burden associated with PDs and MSDs is poorly understood, as is their underlying mechanisms.

Discussion: This scoping review might prompt further research into PDs and MSDs as separate groups of disorders, along with their comorbidity and the mechanisms that may link them.

Systematic review registration: https://osf.io/mxbr2/registrations.

Keywords: comorbidity; comorbidity [MeSH]; musculoskeletal; musculoskeletal diseases; personality disorder; personality disorder (MeSH); review; scoping review.

Publication types

Systematic Review

Grants and funding

LJW was supported by a NHMRC Emerging Leadership Fellowship (1174060). HK-H and SEQ were supported by the Päivikki and Sakari Sohlberg Foundation (7679) and the Signe and Ane Gyllenberg Foundation (5525 and 5799), Finland. JH was supported by the Päivikki and Sakari Sohlberg Foundation (7679) and the Signe and Ane Gyllenberg Foundation (5525).