Patterns of pain perception in individuals with anxiety or depressive disorders: A systematic review and meta-analysis of experimental pain research

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2025-08-13 DOI:10.1016/j.jpain.2025.105530

Jesús Salas-González , Alberto Marcos Heredia-Rizo , Hermann Fricke-Comellas , Ruth L. Chimenti , María Jesús Casuso-Holgado

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引用次数: 0

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 (1460 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 (95% CI −.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.

Registration

OSF (doi:10.17605/OSF.IO/U453J).

Perspective

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.

查看原文本刊更多论文

焦虑或抑郁障碍患者的疼痛感知模式：实验疼痛研究的系统回顾和荟萃分析。

有或没有精神疾病的成年人在疼痛反应上的差异是有文献记载的，但关于这一主题的证据的确定性尚未得到评估。我们检查了被诊断为焦虑或抑郁障碍的个体对实验诱导的疼痛的反应，并与没有精神健康状况的对照组进行了比较。我们还探讨了疼痛方式的影响以及疼痛感知与症状严重程度之间的关联。PubMed， CINAHL, PsycINFO， Cochrane和Embase从成立到2025年3月进行了检索。纳入的研究报告了焦虑或抑郁的成年人，没有并发慢性疼痛和健康对照的疼痛测量（疼痛阈值，强度，耐受性，不愉快）。JBI分析性横断面研究和预后质量研究检查表评估了偏倚风险。证据的确定性通过推荐、评估、发展和评价分级（GRADE）方法来判断。纳入了28项研究（1460名参与者，935名女性），其中大多数存在中至高偏倚风险。与对照组相比，抑郁症患者表现出更高的疼痛阈值[SMD = - 0.30](-。60, - 0.01)]和疼痛强度[SMD =.47]（95% CI.08,.86）]，而焦虑患者表现出较低的疼痛阈值[SMD = - 0.39](95% ci -。61, - 0.17)]（评分：所有结果都非常低）。结果因疼痛方式不同而不同。疼痛阈值与抑郁严重程度中度相关：r =.437(95% CI.208 .621)。数据表明疼痛感知模式明显改变，其特征是抑郁时疼痛阈值较高，焦虑时疼痛阈值较低。成人抑郁症患者可能对缺血刺激特别敏感，但不限于此。注册：OSF （doi:10.17605/OSF. io /U453J）。观点：本系统综述评估了焦虑或抑郁患者的疼痛感知模式如何不同。很少有研究包括焦虑患者，控制合并症，或最近进行的，因此在解释我们的研究结果之前需要谨慎。这强调需要对这一领域进行更新和方法上可靠的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.