Journal article
Patterns of pain perception in individuals with anxiety or depressive disorders: a systematic review and meta-analysis of experimental pain research
The journal of pain, Vol.35, 105530
10/2025
DOI: 10.1016/j.jpain.2025.105530
PMID: 40816613
Abstract
Differences in pain responses between adults with or without psychiatric conditions are documented, yet the certainty of evidence on the topic has not been assessed. We examined pain responses to experimentally induced pain in individuals diagnosed with anxiety or depressive disorders compared to controls without mental health conditions. We also explored the influence of pain modality and associations between pain perception and symptoms severity. PubMed, CINAHL, PsycINFO, Cochrane, and Embase were searched from inception to March 2025. Included studies reported pain measures (pain threshold, intensity, tolerance, unpleasantness) in adults with anxiety or depression, without co-occurring chronic pain, and healthy controls. The JBI Checklist for Analytical Cross-Sectional Studies and the Quality in Prognosis Studies assessed risk of bias. Certainty of evidence was judged by the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Twenty-eight studies (1,460 participants, 935 females) were included, most presenting moderate to high risk of bias. Compared to controls, individuals with depression exhibit higher pain thresholds [SMD = -.30 (-.60, -.01)] and pain intensity [SMD =.47 (95% CI.08,.86)], while those with anxiety exhibit lower pain thresholds [SMD = -.39 (95%CI -.61, -.17)] (GRADE: very low for all outcomes). Results differed depending on pain modality. Pain threshold was moderately correlated with depression severity: r =.437 (95% CI.208,.621). The data suggest distinct altered pain perception patterns, characterized by higher pain thresholds in depression and lower pain thresholds in anxiety. Adults with depression may be particularly sensitive, but not restricted to, ischemic stimuli.
OSF (doi:10.17605/OSF.IO/U453J).
This systematic review assessed how pain perception patterns may differ in individuals with anxiety or depression. Few studies included participants with anxiety, controlled for comorbidities, or were recently conducted, thus caution is needed before interpreting our findings. This underscores the need for updated and methodologically robust research on this field.
•Pain perception patterns seem to differ between individuals with anxiety or depressive disorders.•Adults with depressive disorders exhibit higher pain and sensory thresholds than controls.•Adults with anxiety disorders exhibit lower pain thresholds than controls.•In individuals with depression, pain responses may depend on the modality of painful stimulation.•The certainty of evidence was very low, thus current findings must be interpreted cautiously.
Details
- Title: Subtitle
- Patterns of pain perception in individuals with anxiety or depressive disorders: a systematic review and meta-analysis of experimental pain research
- Creators
- Jesús Salas-González - Universidad de SevillaAlberto Marcos Heredia-Rizo - Instituto de Biomedicina de SevillaHermann Fricke-Comellas - Universidad de SevillaRuth L. Chimenti - University of IowaMaría Jesús Casuso-Holgado - Instituto de Biomedicina de Sevilla
- Resource Type
- Journal article
- Publication Details
- The journal of pain, Vol.35, 105530
- DOI
- 10.1016/j.jpain.2025.105530
- PMID
- 40816613
- NLM abbreviation
- J Pain
- ISSN
- 1526-5900
- eISSN
- 1528-8447
- Publisher
- Elsevier Inc
- Language
- English
- Electronic publication date
- 08/13/2025
- Date published
- 10/2025
- Academic Unit
- Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984948003502771
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