Depression, Anxiety in Youth with Chronic Pain: Daily Dose

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On October 2, 2024, we reported on findings from a study published in JAMA Pediatrics that examined the prevalence of anxiety and depression in US youth with chronic pain.

The study

Researchers conducted a systematic review and meta-analysis of 79 studies published between 1997 and 2023 that included a total of 22 956 individuals aged less than 25 years (74% girls; mean age 13.7 years; range, 4-24 years). Of the total cohort, 12 614 had chronic pain and 10 342 were controls. They determined the prevalence of anxiety and depression diagnoses using event rate calculations and calculated between-group differences in symptoms using Hedges g.

The findings

Data from 12 studies with 780 participants showed that 34.6% (95% CI 24.0%-47.0%) of youth with chronic pain met the diagnostic criteria for anxiety disorder. Findings from 12 studies with 814 participants showed that 12.2% (95% CI 7.8%-18.7%) of youth with chronic pain met diagnostic criteria for depression.

A total of 23 studies with 30 independent comparisons reported data no anxiety symptom scores for 4605 participants with chronic pain and 9224 control participants. Results showed that the pooled effect size was significant and medium to large (g = 0.61, 95% CI 0.46-0.77), “suggesting that youth with chronic pain report more severe anxiety symptoms compared with controls,” researchers wrote

With regards to depression, 33 studies with 40 independent comparisons reported symptom scores for pain (n=5128) and control (n=9248) groups. Similar to anxiety, the pooled effect size was significant and medium to large (g = 0.74, 95% CI 0.63-0.85), indicating that participants with chronic pain had more severe symptoms of depression than their pain-free peers.

Authors' comment

"The results represent a major clinical comorbidity for this population. As such, it is imperative that anxiety and depression be considered alongside pain and disability when assessing younger people with chronic pain and, if relevant, that younger people be provided access to timely psychological care to improve pain outcomes alongside mental health."

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