Millions of U.S. adults experience the co-occurrence of chronic pain and mental health symptoms

Reviewed by Lily Ramsey, LLMSep 21 2023

New University of Arizona Health Sciences research recently published in the journal PAIN found that nearly 1 in 20 adults in the U.S. experience the co-occurrence of chronic pain and anxiety or depression, resulting in functional limitations in daily life.

Prior research has shown that chronic pain along with symptoms of anxiety or depression are biologically linked. This study is one of the few to examine the national prevalence of chronic pain with anxiety or depression symptoms in adults. The results shed light on the fact that millions of people may be experiencing symptoms that can limit their ability to work, complete daily tasks and socialize.

"The study's findings highlight an underappreciated population and health care need – the interdependency between mental health and chronic pain," said the paper's lead author Jennifer S. De La Rosa, PhD, director of strategy for the UArizona Health Sciences Comprehensive Pain and Addiction Center, which funded the study. "This work is so exciting because it offers the opportunity to use team-based interdisciplinary approaches to medicine, leveraging what is known across disciplines to meet the needs of these individuals."

The study, "Co-Occurrence of Chronic Pain and Anxiety/Depression Symptoms in U.S. Adults: Prevalence, Functional Impacts, and Opportunities," found that approximately 12 million people, or 4.9% of the United States adult population, have co-occurring chronic pain and anxiety or depression symptoms.

The research team analyzed data from 31,997 people who participated in the National Health Interview Survey, which has been identified as the best single source for surveillance of chronic pain.

Adults with chronic pain were approximately five times more likely to report anxiety or depression symptoms compared with those without chronic pain. And, among all U.S. adults living today with unremitted anxiety or depression, the majority (55.6%) are people who also have chronic pain.

Additionally, the effects of co-occurring anxiety or depression symptoms and chronic pain negatively affected daily activities more than either condition alone. Nearly 70% of people with co-occurring symptoms reported limitations at work, more than 55% reported difficulty taking part in social endeavors and almost 44% were more likely to have difficulty doing errands alone.

"I was surprised by the magnitude of the effect with functional limitations," said De La Rosa, who also is an assistant research professor in the UArizona College of Medicine – Tucson's Department of Family and Community Medicine. "Across all domains of functional activity in life, we saw an enormous jump among people who are living with both conditions. These are people who are at a high risk for functional limitation, which will disturb their quality of life."

Future studies could look at whether those receiving pain treatment are receiving mental health care and whether that care is remitting symptoms.

When someone is experiencing both chronic pain and anxiety or depression symptoms, achieving positive health outcomes can become more challenging. This study gives us another avenue to explore in our continuing effort to find new ways to treat chronic pain."

Todd Vanderah, PhD, senior author, director of the Comprehensive Pain and Addiction Center, professor and head of the Department of Pharmacology in the College of Medicine – Tucson and BIO5 Institute member

Other co-authors from the UArizona Health Sciences Comprehensive Pain and Addiction Center include Associate Director of Medical Affairs Mohab M. Ibrahim, PhD, MD, professor of anesthesiology at the UArizona College of Medicine – Tucson and director of the Chronic Pain Management Clinic; Assistant Director of Operations Alyssa R. Padilla, MPH; and Benjamin R. Brady, DrPH, adjunct assistant research professor at the Mel and Enid Zuckerman College of Public Health. Additional co-authors are Katherine E. Herder, MPH, doctoral student in the Zuckerman College of Public Health; and Jessica S. Wallace, program evaluator at the Department of Family and Community Medicine in the College of Medicine – Tucson.