Despite the challenges of arthritis and chronic pain, a majority of Canadians living with these conditions enjoy excellent mental health, with sleep emerging as a key factor in overall well-being.

The study, led by researchers at the University of Toronto and published in PLOS ONE, found majority (76%) of these individuals with arthritis or chronic pain were free of any mental illness in the past year, including depression.  

More than half (56%) of the respondents went beyond just being free of psychiatric disorders to achieving excellent mental health. To be defined in excellent mental health, respondents had to achieve three things: one, almost daily happiness or life satisfaction in the past month; two, high levels of social and psychological well-being in the past month; and three, freedom from generalized anxiety disorder and depressive disorders, suicidal thoughts, and substance dependence for at least the preceding full year.

Consistent with earlier studies, this study found insomnia to be negatively associated with mental health. Researchers found the prevalence of both the absence of psychiatric disorders and complete mental health was higher among those who self-reported never to sometimes having sleep problems compared to those who self-reported most of the time having sleep problems.

Those with sleep problems and a history of psychiatric disorders were at a disadvantage, underlining the importance of providing appropriate treatment for these issues.

Individuals without sleep problems were more than twice as likely to be in the absence of psychiatric disorders and complete mental health.

“These findings underscore the importance of health professionals asking about sleep problems, particularly as chronic pain can undermine the quality of sleep,” says co-author Denise Marshall, a recent graduate of the U of T Institute’s Factor-Inwentash Faculty of Social Work, in a release. “Among individuals with chronic pain, cognitive behavioral therapy (or CBT) has been shown to significantly reduce insomnia. CBT is an already established effective and relatively rapid treatment for depression and anxiety in the general population and among those with chronic pain.”

Other factors associated with excellent mental health in the year preceding the survey included having a confidant and having no previous history of major depressive disorder and/or generalized anxiety disorder.

“The current research shifts away from a deficit-focused approach to mental health among individuals with arthritis and instead uses a strengths-based perspective to explore factors associated with resilience in individuals with arthritis who are experiencing chronic and disabling pain,” says co-author Sally Abudiab, who also recently graduated from the U of T Institute’s Factor-Inwentash Faculty of Social Work, in a release. The study investigated factors associated with mental flourishing in a nationally representative sample of 620 Canadian adults drawn from the Canadian Community Health Survey-Mental Health who had been diagnosed with arthritis who are living with disabling chronic pain.

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