A recent meta-analysis reveals that young individuals suffering from chronic pain exhibit significantly higher rates of anxiety and depression compared to their peers. The comprehensive review, which analyzed 79 studies involving nearly 23,000 youth, found that 34.6% of those with chronic pain experienced anxiety, and 12.2% reported depression. These figures are more than three times higher than the rates observed in the general population, according to the study published in JAMA Pediatrics.
The analysis highlighted that youth with chronic pain not only experience higher prevalence rates of anxiety and depression but also demonstrate more severe symptoms compared to controls. The effect sizes for these differences were classified as medium to large, underscoring the significant disparity in mental health between those with and without chronic pain.
Dr. Joanne Dudeney of Macquarie University, Sydney, and her team conducted the study, noting, “Rates of depression and anxiety are quite high among these youths. Many are simultaneously coping with the distressing symptoms of these mental health conditions.”
Dr. Rachel Aaron from Johns Hopkins University emphasized that while the overlap of chronic pain with depression and anxiety is notable, most children with chronic pain do not exhibit these psychological symptoms. “It is important to understand that chronic pain alone does not necessarily lead to depression,” Aaron stated. “However, the findings highlight the need for enhanced mental health screening, prevention, and treatment for these youths.”
The study calls for improved mental health support within healthcare settings that cater to youth with chronic pain. Aaron suggested that medical professionals should ensure streamlined mental health referrals and seek additional training to better address the complexities of treating chronic pain coupled with mental health issues.
The research team conducted a thorough literature review, gathering data from MEDLINE, PsycINFO, CENTRAL, and Embase up until April 30, 2023. The review included 22,956 youth, with 12,614 suffering from chronic pain and 10,342 serving as controls. The cohort was predominantly female (74%) with a mean age of 13.7 years, spanning from 4 to 24 years.
The study identified that 23.9% of youth with chronic pain had anxiety levels exceeding clinical thresholds, and 23.5% had depression levels above clinical cutoffs. Various diagnostic tools were used across the studies, including the Kiddie Schedule for Affective Disorders and Schizophrenia, as well as several symptom questionnaires such as the Children’s Depression Inventory and Revised Child Anxiety and Depression Scale.
The researchers acknowledged limitations in their study, including the inability to determine the onset of anxiety and depression relative to chronic pain due to the cross-sectional nature of the data. Additionally, the exclusion of youths with severe psychiatric conditions in some studies may have led to an underestimation of the prevalence of anxiety and depression.
Future research is needed to focus on clinical trials aimed at developing effective treatments for depression and anxiety in youths with chronic pain. “Current psychological therapies for pain are not tailored to address depression and anxiety,” Aaron noted. “There is a pressing need for treatments designed specifically for children facing both chronic pain and mental health challenges.”
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