Introduction: Musculoskeletal pain accompanied by psychological problem lead to reduce the efficiency of adolescents; so, this study aimed to determine the prevalence of musculoskeletal pain and its association with psychological factors among female adolescents.

Materials and methods: The target population of this cross sectional study was female students (3625 in total) from both private and state funded high school children in Gorgan, northern Iran. Self - assessment questionnaires were distributed to 255 students across 8 female high schools. Self-report version of the Strengths and Difficulties (SDQ) questionnaires was used to screen adolescents with Psychiatric symptoms. To evaluate musculoskeletal pain Nordic questionnaire and numeric pain rating scale was used. Data were analyzed by binary logistic regression and the cumulative odds ratio (COR) was carried out for the ordinal level of musculoskeletal symptoms.

Results: The prevalence rate of neck, shoulder and low back pain was reported, 23.1%, 27.8% and 27.7%, respectively.  Hyperactivity-inattention (OR=2. 82; CI: 1.14-6.97) and peer problem (OR= 2.72; CI: 1.01-7.32) had significant relationship with neck pain, and prosocial behaviors (OR= 3.11; CI: 1.09-10.73) were associated with low back pain in the multivariate model. Ordinal regression showed that the increasing numbers of musculoskeletal symptoms related only to prosocial behavior (COR= 2.78; CI: 1.12-6.91). There was no significant association between shoulder pain and psychological factors.

Conclusion: Based on the results, psychological factors were associated with musculoskeletal pain; so, it seems suffering from musculoskeletal pain need to be concurrently noticed with mental feeling for more effective response to attenuate pain.