Bad news!
"Medical researchers are calling for changes in the treatment of chronic pain, with more routine screening for depression and anxiety among patients.
It comes after a systematic review of the literature found that about 40% of adults living with chronic pain also have clinical depression or anxiety. ...
It found that the prevalence of depression and anxiety was highest among women, younger people, and individuals with “nociplastic” chronic pain, like fibromyalgia, complex regional pain syndrome, and temporal mandibular disorder. ..."
From the key points and abstract:
"Key Points
Question
How prevalent are depression and anxiety among adults with chronic pain?
Findings
This systematic review and meta-analysis identified 376 studies comprising 347 468 individuals with chronic pain from 50 countries, with a pooled prevalence of 39.3% for depression and 40.2% for anxiety; the prevalences were highest among samples of people with fibromyalgia and samples of people who were younger and predominantly female. The prevalences of depression and anxiety were significantly higher among individuals with chronic pain than in both clinical and nonclinical control groups.
Meaning
This study suggests that the prevalences of depression and anxiety among adults with chronic pain are approximately 40%; to address this significant public health concern, it is essential to routinely screen for mental health symptoms in clinical settings where people with chronic pain are treated.
Abstract
Importance
Depression and anxiety are common among adults with chronic pain, but their prevalence is unclear.
Objectives
To evaluate the prevalence of depression and anxiety among adults with chronic pain and identify factors that moderate prevalence.
Data Sources
A literature search was conducted of MEDLINE, Embase, PsycINFO, and Cochrane Library from January 2013 to October 2023.
Study Selection
Studies reporting the prevalence of depression or anxiety using a validated assessment tool among adults with chronic pain (excluding chronic headache disorders).
Data Extraction and Synthesis
A total of 31 159 initial records were identified, and 5177 full texts were screened. Data were extracted per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline using Covidence. Two independent reviewers completed abstract screening, full-text review, and data extraction and rated risk of bias. Random-effects meta-analyses were applied to pool prevalence, assess moderation, and compare prevalence of depression or anxiety among samples with chronic pain vs control samples.
Main Outcomes and Measures
Prevalence of depression and anxiety based on clinically significant symptoms or diagnosis. The moderators of prevalence identified were pain condition, recruitment setting, continent, age, percentage female, and pain duration.
Results
The search identified 376 studies from 50 countries comprising 347 468 individuals (mean [SD] age, 51.3 [9.5] years; 70.0% female) with chronic pain. Among adults with chronic pain, clinical symptoms of depression were present in 39.3% (95% CI, 37.3%-41.1%; I2 = 98.9%), and clinical symptoms of anxiety were present in 40.2% (95% CI, 38.0%-42.4%; I2 = 99.0%).
Prevalence differed by pain condition (highest among samples of people with fibromyalgia [depression, 54.0% (95% CI, 48.5%-59.4%); anxiety, 55.5% (95% CI, 50.4%-60.4%)]; lowest among samples of people with arthritis conditions [eg, osteoarthritis: depression, 29.1% (95% CI, 20.3%-39.7%); anxiety, 17.5% (95% CI, 6.6%-38.8%)]) and was highest among younger people (depression, β = −0.02 [95% CI, −0.03 to −0.01]; anxiety, β = −0.02 [95% CI, –0.03 to –0.01]) and women (depression, β = 0.69 [95% CI, 0.31-1.08]; anxiety, β = 0.90 [95% CI, 0.48-1.33]). With regard to diagnoses, 36.7% (95% CI, 29.0%-45.1%) had a major depressive disorder, and 16.7% (95% CI, 11.8%-23.2%) had generalized anxiety disorder. Women, younger people, and people with nociplastic pain (ie, pain arising from altered nociception without tissue damage) were most likely to have depression and anxiety.
Conclusions and Relevance
In this systematic review and meta-analysis of depression and anxiety among individuals with chronic pain, approximately 40% of adults had clinically significant depression and anxiety. Women, younger people, and people with nociplastic pain were most likely to have depression and anxiety. The co-occurrence of chronic pain with depression and anxiety is a significant public health concern necessitating routine screening in clinical settings, equitable access to specialty care, and innovative treatment development."
Worldwide Study Finds High Rates of Depression and Anxiety in People with Chronic Pain "A Systematic Review and Meta-Analysis" (original news release)
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