Depression and anxiety affect approximately 40% of adults with chronic pain, according to a massive new [systematic review and meta-analysis](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2025.0268?guestAccessKey=c0957767-f5eb-4d6d-88a4-15c747418b57&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=030725) published in _JAMA Network Open_. The comprehensive study analyzed data from 376 studies comprising 347,468 individuals with chronic pain (mean age 51.3 years) from 50 countries.
The analysis revealed that clinical symptoms of [depression](https://www.mcknights.com/news/more-physical-activity-linked-to-lower-risk-of-dementia-depression-study/) were present in 39.3% of chronic pain patients, while clinical symptoms of anxiety affected 40.2%. These rates were significantly higher than in both comparison groups: people with other medical conditions but no chronic pain (clinical controls) and healthy individuals without medical conditions (nonclinical controls).
Among different pain conditions, those with fibromyalgia experienced the highest prevalence of both depression (54%) and anxiety (55.5%), while people with arthritis conditions showed the lowest rates. For example, those with osteoarthritis had depression rates of 29.1% and anxiety rates of 17.5%.
Notable demographic patterns emerged from the data. Women and younger individuals were more likely to experience depression and anxiety alongside their chronic pain.
Additionally, the study revealed significant differences in mental health outcomes based on pain mechanism:
* Individuals with nociplastic pain, pain resulting from altered nervous system processing without evidence of actual tissue damage, reported the highest rates of mental health conditions.
* Those with neuropathic pain, pain caused by damage or disease affecting the somatosensory nervous system, showed moderate levels of comorbid mental health issues.
* Patients experiencing nociceptive pain, pain arising from actual or threatened damage to non-neural tissue due to activation of nociceptors, had the lowest rates of associated mental health conditions.
The study also found that among adults with chronic pain, 36.7% met diagnostic criteria for major depressive disorder, and 16.7% for generalized anxiety disorder, rates markedly higher than in the general population.
“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,” according to the study authors.
They noted that these findings underscore the need for integrated treatment approaches that address both pain management and mental health care, especially for those at highest risk. The study authors concluded that their present findings underscore a need for developing and scaling targeted treatments that address co-occurring chronic pain and depression and anxiety.