587: ICEPAIN: National Longitudinal Cohort Advancing Multidimensional Understanding of Pain Trajectories

Topic: Education, Societal Impact, and Others
Subtopic: Epidemiology

Background and Aims: Chronic pain is a complex, personal, condition shaped by biological, psychological, social, and behavioural influences. Although it may originate from injury or pathology, its persistence and impact are strongly influenced by health behaviours, socioeconomic conditions, trauma exposure, and psychosocial vulnerability. Moving beyond biomedical models toward a multidimensional framework is essential. Large-scale longitudinal population studies integrating biomedical, psychosocial, and lifestyle domains are needed to inform prevention strategies and health policy.
This study aims to develop and expand a nationally representative longitudinal cohort (ICEPAIN) mapping pain prevalence, trajectories, and associated psychosocial and lifestyle determinants, with global applicability.

Methods: ICEPAIN-1 (2021) surveyed Icelandic adults, 18–80 years drawn from a stratified national panel reflecting the population register. Of 12,400 invited, participants 5,557 (44.7%) completed a web-based questionnaire including validated measures of pain (Brief Pain Inventory), quality of life (SF-12v2), lifestyle behaviours, adverse childhood experiences (ACE), adult interpersonal violence, and sociodemographic factors. Chronic pain was defined as pain lasting >3 months. Multivariable models estimated prevalence ratios adjusted for age, gender, and education. Eighty-one percent of participants consented to be recontacted and will be followed in ICEPAIN-2 (2026), enabling five-year longitudinal analyses of pain transitions and associated risk and protective factors.

Results: Half of participants reported pain in the previous week, and 40% reported chronic pain. Chronic pain was socially patterned, with higher prevalence among women, middle-aged adults, individuals with lower education and financial strain, and those exposed to trauma. Associations were observed between chronic pain and sleep disturbance, lower physical activity, smoking, higher BMI, and ACE. Chronic pain was associated with significantly reduced physical and mental HRQoL, particularly among individuals reporting constant or daily pain patterns, indicating substantial functional and psychosocial burden.

Conclusions: By integrating psychosocial adversity, behavioural factors, and HRQoL within a population-based longitudinal framework, ICEPAIN provides a multidimensional model for national pain surveillance and cross-national comparison. ICEPAIN-2 will generate a five-year map of pain trajectories, advancing mechanistic understanding of chronification and informing international guidelines and policy. The platform identifies modifiable risk and protective factors, supports equitable and trauma-informed care, and strengthens prevention-oriented strategies to reduce the long-term burden of chronic pain.

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Presenting Author: Thorbjorg Jonsdottir
Submitting Author: Thorbjörg Jonsdottir

Senior Author: Thorbjorg Jonsdottir

IASP 2026 Global Year theme of Neuropathic Pain: No

• Eva Halapi: PhD - University of Akureyri
• Hafdis Skuladottir: PhD - University of Akureyri
• Sigfridur Inga Karsldottir: PhD - University of Akureyri
• Gudmundur Kristjan Oskarsson: Cand. Oecon - University of Akureyri