Depression, Anxiety More Prevalent Among Women With Chronic Pain
The prevalence of depression and anxiety were also higher among younger patients and those who had a longer duration of pain.
A significant amount of patients with chronic pain are also impacted by co-occurring depression and anxiety, according to a new study published in JAMA Network Open.1 The data, which also showed the conditions are more prevalent among women, highlight the critical need for routine mental health screening among patients with chronic pain.
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Mental illness and chronic pain frequently occur together, with research pointing to a possible bidirectional relationship. Data shows that 12 million adults in the United States deal with co-occurring chronic pain and anxiety or depression, which is now recognized as a serious public health concern.2 The authors of that study said that research to address unmet needs and improve outcomes must be prioritized.
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“Not only are few treatments available for these comorbidities, but people with mental health comorbidities are frequently rejected from chronic pain clinics and excluded from clinical trials,” the authors wrote. “Addressing this gap will help guide public health initiatives and inform treatment development to promote positive health outcomes for people with chronic pain.”
A team of investigators conducted a study to evaluate the prevalence of depression and anxiety among adults with chronic pain and to identify factors that moderate prevalence. Data for the study was collected from a search of MEDLINE, Embase, PsychINFO, and Cochrane Library from January 2013 to October 2023. Studies were included if they reported on the prevalence of depression and anxiety among adults with any chronic pain condition.
A total of 376 studies, representing 347468 adult patients with chronic pain and 160564 control patients, were included. The mean age among patients was 51.3 years and 70% were female. The most common chronic pain conditions were mixed, fibromyalgia, chronic low back pain, and rheumatoid arthritis. The included studies were conducted in 50 countries, with the most common being the UK.
The study found that pooled prevalence of clinical symptoms of depression was 39.3%, with the highest prevalence being among patients with fibromyalgia. The pooled prevalence of clinical symptoms of anxiety was 40.2%, with the highest prevalence again being among patients with fibromyalgia. The prevalence of depression and anxiety were higher among younger patients, female patients, and those who had a longer duration of pain.
Study limitations included that all study type were included, that heterogeneity in the study is largely unexplained, that only a small number of studies reported on race or ethnicity, that some studies did not adhere to recommended clinical cutoff scores, and that the quality of approximately one-third of the studies were rated poor for their assessment of depression and anxiety among patients.
“Few psychological treatments are available to treat chronic pain and co-occurring depression and anxiety, although treatments that adopt an embodied approach and incorporate affective targets of intervention may be more effective for people with heightened mental health symptoms,” the authors concluded. “The present findings underscore the need for developing and scaling targeted treatments that address co-occurring chronic pain and depression and anxiety.”
READ MORE: Women's Health Resource Center
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