Tucson Standard

A new University of Arizona Health Sciences study has revealed that adults with chronic pain are more likely to experience symptoms of anxiety and depression compared to those without chronic pain. Despite this, they access mental health care at lower rates and are less likely to have their mental health needs adequately addressed.

In 2021, approximately 51.6 million U.S. adults experienced chronic pain, according to the Centers for Disease Control and Prevention. The study indicates that while people living with chronic pain constitute 20.4% of the U.S. adult population, they represent an estimated 55.5% of U.S. adults with clinically significant anxiety and depression symptoms.

"People living with chronic pain may form a distinct population with special mental health care needs," said lead author Jennifer S. De La Rosa, strategy director for the U of A Health Sciences Comprehensive Center for Pain & Addiction, which funded the study. "Improving outcomes for people with chronic pain will include connecting more people to mental health care, as well as increasing the availability of mental health care that is responsive to their needs."

The paper, "The unmet mental health needs of U.S. adults living with chronic pain," was recently published in the journal PAIN.

This research builds on previous findings from the Comprehensive Center for Pain & Addiction, which noted that one in twenty U.S. adults suffers from both chronic pain and symptoms of anxiety or depression. Adults living with chronic pain are approximately five times more likely to have untreated symptoms of anxiety or depression compared to those without chronic pain.

The new study examined how individuals with chronic pain and mental health symptoms accessed and benefited from mental health treatment by analyzing data from 31,997 participants in the National Health Interview Survey.

Researchers identified disparities related to three areas: the need for mental health treatment; the use of such treatment; and its success in alleviating anxiety and depression symptoms when used.

They found that 43.2% of U.S. adults living with chronic pain—approximately 21.5 million people—had a mental health need, compared to only 17.4% among those without chronic pain.

Among all U.S. adults needing mental health treatment, having chronic pain was associated with a 40.3% reduction in the odds of using such services.

"For those with chronic pain, the narrative about what needs to be done to address mental health is qualitatively different than for those who don't have chronic pain," said De La Rosa, who is also an assistant research professor in the U of A College of Medicine – Tucson's Department of Family and Community Medicine. "Improving healthcare for people with chronic pain includes not only connecting people to care but also addressing a disproportionate failure to achieve relief even within caregiving contexts."

When utilizing mental health treatment, individuals with chronic pain were found to be more than twice as likely as others to continue experiencing anxiety or depression symptoms.

The study team discovered that only 44.4% of individuals with chronic pain—an estimated 9.5 million people—used mental health services effectively enough to treat their anxiety and depression symptoms adequately compared to 71.5% among those without chronic pain.

"There are many possible reasons an individual with chronic pain might have suboptimal mental health experiences," De La Rosa said, citing accessibility issues and feasibility concerns regarding appointments as contributing factors. Additionally, few providers are trained specifically in treating patients suffering from both conditions concurrently.

"This study identified a significant gap in meeting the mental health needs of people who live with chronic pain," said Regents Professor Todd Vanderah, senior study author and director of the Comprehensive Center for Pain & Addiction at U of A College of Medicine – Tucson's Department of Pharmacology and BIO5 Institute member."Our goal at the Comprehensive Center for Pain & Addiction is to use this information to reimagine and transform healthcare for chronic pain."

Other co-authors from the Comprehensive Center include medical director Mohab Ibrahim; policy director Beth E Meyerson; Alicia M Allen; Kyle Suhr; Benjamin R Brady; doctoral student Katherine E Herder; and Jessica S Wallace.

A version originally appeared on the University’s Health Sciences website.