Depression and Anxiety Affect 40 Percent of Adults With Chronic Pain: JAMA

The study highlights that certain groups are more susceptible to these mental health conditions. Women and younger adults were found to have a higher likelihood of experiencing depression and anxiety in the context of chronic pain. Additionally, individuals with nociplastic pain—a type of pain associated with altered central pain processing rather than direct tissue damage—were particularly vulnerable.

The researchers note that depression and anxiety are frequently observed among adults with chronic pain, yet their exact prevalence remains uncertain. Considering this, Rachel V. Aaron, Johns Hopkins University School of Medicine, Baltimore, Maryland, and colleagues aimed to assess the extent of these mental health conditions in individuals experiencing chronic pain while also identifying factors that influence their occurrence.

For this purpose, the researchers conducted a literature search across MEDLINE, Embase, PsycINFO, and Cochrane Library from January 2013 to October 2023. They analyzed studies that reported the prevalence of depression or anxiety using validated assessment tools among adults with chronic pain, excluding chronic headache disorders. From 31,159 initial records, 5177 full texts were screened, and data extraction followed PRISMA guidelines using Covidence.

Two independent reviewers assessed bias and conducted meta-analyses to pool prevalence and identify moderators, including pain condition, recruitment setting, age, gender, and pain duration. The study compared depression and anxiety prevalence in chronic pain versus control groups.

The study led to the following findings:

• The study analyzed 376 studies from 50 countries, including 347,468 individuals with chronic pain (average age 51.3 years, 70% female).
• Clinical symptoms of depression were found in 39.3% of adults with chronic pain, while anxiety symptoms were present in 40.2%.
• Prevalence varied by pain condition, with the highest rates in fibromyalgia (depression: 54.0%, anxiety: 55.5%) and the lowest in arthritis (e.g., osteoarthritis: depression: 29.1%, anxiety: 17.5%).
• Depression and anxiety were more common among younger individuals and women.
• Diagnosed major depressive disorder was present in 36.7%, while generalized anxiety disorder was found in 16.7%.
• People with nociplastic pain were most affected.

"The coexistence of chronic pain with depression and anxiety poses a major public health challenge, highlighting the need for routine mental health screening in clinical practice. Ensuring equitable access to specialized care and developing innovative treatment approaches are essential to address this dual burden and improve patient outcomes effectively," the researchers concluded.

Reference:

Aaron RV, Ravyts SG, Carnahan ND, et al. Prevalence of Depression and Anxiety Among Adults With Chronic Pain: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2025;8(3):e250268. doi:10.1001/jamanetworkopen.2025.0268