Cited by 239Musculoskeletal pain and rehabilitationPain Management and TreatmentPediatric Pain Management Techniques

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Psychological functioning of people living with chronic pain: a meta-analytic review

Burke, Anne L. J., Mathias, Jane L., Denson, Linley A.·2015·British Journal of Clinical Psychology

DOI 10.1111/bjc.12078

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Abstract

Objectives Chronic pain (CP; >3 months) is a common condition that is associated with significant psychological problems. Many people with CP do not fit into discrete diagnostic categories, limiting the applicability of research that is specific to a particular pain diagnosis. This meta-analysis synthesized the large extant literature from a general CP, rather than diagnosis-specific, perspective to systematically identify and compare the psychological problems most commonly associated with CP. Methods Four databases were searched from inception to December 2013 (PsychINFO, The Cochrane Library, Scopus, and PubMed) for studies comparing the psychological functioning of adults with CP to healthy controls. Data from 110 studies were meta-analysed and Cohen's d effect sizes calculated. Results The CP group reported experiencing significant problems in a range of psychological domains (depression, anxiety, somatization, anger/hostility, self-efficacy, self-esteem and general emotional functioning), with the largest effects observed for pain anxiety/concern and somatization; followed by anxiety and self-efficacy; and then depression, anger/hostility, self-esteem and general emotional functioning. Conclusions This study demonstrates, for the first time, that individuals with CP are more likely to experience physically focussed psychological problems than other psychological problems and that, unlike self-efficacy, fear of pain is intrinsically tied to the CP experience. This challe…

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Evans, M. C., Bazargan, M., Cobb, S., & Assari, S. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16203894 · Cited by 21
“Depressive symptoms have been linked to pain [55], and this relationship appears especially strong in AA and older adult samples [7,14,25,56].”
Background
Diet and companionship modulate pain via a serotonergic mechanism
Tran, H., Sagi, V., Jarrett, S., Palzer, E. F., Badgaiyan, R. D., & Gupta, K. (2021) · Scientific Reports · doi:10.1038/s41598-021-81654-1 · Cited by 21
Post-traumatic growth amongst UK armed forces personnel who were deployed to Afghanistan and the role of combat injury, mental health and pain: the ADVANCE cohort study
Dyball, D. M., Bennett, A. N., Schofield, S. J., Cullinan, P., Boos, C. J., Bull, A. M. J., Stevelink, S. A. M., & Fear, N. T. (2022) · Psychological Medicine · doi:10.1017/s0033291722002410 · Cited by 25
“Given the known relationship between pain and other factors of general well-being and functioning (Burke, Mathias, & Denson, 2015), further investigation into pain and PTG amongst injured UK military personnel is warranted.”
Background
Changes in Pain Perception following Psychotherapy: The Mediating Role of Psychological Components
Zanini, S., Voltolini, A., Gragnano, G., Fumagalli, E., & Pagnini, F. (2018) · Pain Research and Management · doi:10.1155/2018/8713084 · Cited by 21
The reliability and validity of the Spanish version of the Fear of Pain Questionnaire
Solé, E., Castarlenas, E., Sánchez‐Rodríguez, E., Galán, S., de la Vega, R., Jensen, M. P., & Miró, J. (2017) · Journal of Health Psychology · doi:10.1177/1359105316686669 · Cited by 21
Obesity is associated with a higher prevalence of musculoskeletal pain in middle-aged women
Blümel, J. E., Arteaga, E., Mezones‐Holguín, E., Zúñiga, M. C., Witis, S., Vallejo, M. S., Tserotas, K., Sánchez, H., Onatra, W., Ojeda, E., et al. (2017) · Gynecological Endocrinology · doi:10.1080/09513590.2016.1269741 · Cited by 20
“depression and anxiety (somatization) [33], two psychological symptoms that we find in our study with a higher prevalence than obesity.”
Background
Convergent validity and clinically relevant categories for the Dutch Central Sensitization Inventory in patients with chronic pain
van der Noord, R., Paap, D., & van Wilgen, C. P. (2018) · Journal of Applied Biobehavioral Research · doi:10.1111/jabr.12119 · Cited by 21
Addressing Chronic Pain Disparities Between Black and White People: A Narrative Review of Socio-Ecological Determinants
Pham, T. V., Doorley, J. D., Kenney, M. O., Joo, J. H., Shallcross, A. J., Kincade, M., Jackson, J., & Vranceanu, A. (2023) · Pain Management · doi:10.2217/pmt-2023-0032 · Cited by 22
Waiting for multidisciplinary chronic pain services: A prospective study over 2.5 years
Burke, A. L. J., Mathias, J. L., & Denson, L. A. (2018) · Journal of Health Psychology · doi:10.1177/1359105317752828 · Cited by 17
“, 2016), psychological (Burke et al., 2015), social (Dueñas et al.”
BackgroundSelf-citation
Profiles of Risk and Resilience in Chronic Pain: Loneliness, Social Support, Mindfulness, and Optimism Coming out of the First Pandemic Year
Wilson, J. M., Colebaugh, C. A., Flowers, K. M., Edwards, R. R., & Schreiber, K. L. (2022) · Pain Medicine · doi:10.1093/pm/pnac079 · Cited by 18
“Patients with chronic pain report elevated levels of psychosocial distress compared with pain-free controls [7, 8].”
Background
The Relationship Between Reminiscence Functions, Optimism, Depressive Symptoms, Physical Activity, and Pain in Older Adults
McDonald, D. D., Shellman, J. M., Graham, L., & Harrison, L. (2016) · Research in Gerontological Nursing · doi:10.3928/19404921-20160531-01 · Cited by 18
Temperament, Beliefs About Pain Control, and Pain Intensity in Endometriosis Patients
Bylinka, J., & Oniszczenko, W. (2016) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-016-9473-8 · Cited by 18
Coping Strategies, Pain Severity, Pain Anxiety, Depression, Positive and Negative Affect in Osteoarthritis Patients; A Mediating and Moderating Model
Sarfraz, R., Aqeel, M., Lactao, J., & Khan, S. (2021) · doi:10.53107/nnjp.v1i1.8 · Cited by 19
“Similar investigation also found that osteoarthritis symptoms were associated with psychopathology including depressive, stress and anxiety symptoms (Burke, Mathias, & Denson, 2015; Mallen et al., 2017; Burston et al., 2019).”
Suicidal ideation in female individuals with fibromyalgia and comorbid obesity: prevalence and association with clinical, pain-related, and psychological factors
Varallo, G., Scarpina, F., Arnison, T., Giusti, E. M., Tenti, M., Rapelli, G., Cattivelli, R., Landi, G., Tossani, E., Grandi, S., et al. (2023) · Pain Medicine · doi:10.1093/pm/pnad139 · Cited by 17
Patient‐reported outcomes and joint status across subgroups of US adults with hemophilia with varying characteristics: Results from the Pain, Functional Impairment, and Quality of Life (P‐FiQ) study
Batt, K., Boggio, L. N., Neff, A. T., Buckner, T. W., Wang, M., Quon, D. V. K., Witkop, M., Recht, M., Kessler, C. M., Iyer, N. N., et al. (2018) · European Journal Of Haematology · doi:10.1111/ejh.13028 · Cited by 17
Mapping the Affective Dimension of Embodiment With the Sensation Manikin: Validation Among Chronic Pain Patients and Modification by Mindfulness-Oriented Recovery Enhancement
Hanley, A. W., & Garland, E. L. (2019) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000725 · Cited by 18
The associations of poor psychiatric well-being among incarcerated men with injecting drug use histories in Victoria, Australia
Cossar, R. D., Stoove, M. A., Kinner, S. A., Dietze, P., Aitken, C. K., Curtis, M., Kirwan, A., & Ogloff, J. R. P. (2018) · Health & Justice · doi:10.1186/s40352-018-0059-4 · Cited by 16
“Chronic pain and disease are well known to impact on psychiatric well-being (Burke et al., 2015), particularly for those with severe mental illness (Miller et al., 2006).”
Background
Associations of Pain Intensity and Frequency With Loneliness, Hostility, and Social Functioning: Cross-Sectional, Longitudinal, and Within-Person Relationships
Boggero, I. A., Sturgeon, J. A., Arewasikporn, A., Castro, S. A., King, C. D., & Segerstrom, S. C. (2019) · International Journal of Behavioral Medicine · doi:10.1007/s12529-019-09776-5 · Cited by 16
Mediational models of pain, mental health, and functioning in individuals with burn injury.
Cariello, A. N., Perrin, P. B., Tyler, C. M., Pierce, B. S., Maher, K. E., Librandi, H., Sutter, M. E., & Feldman, M. J. (2020) · Rehabilitation Psychology · doi:10.1037/rep0000359 · Cited by 15
Does a Brief Educational Session Produce Positive Change for Individuals Waiting for Tertiary Chronic Pain Services?
Burke, A. L. J., Denson, L. A., & Mathias, J. L. (2016) · Pain Medicine · doi:10.1093/pm/pnw125 · Cited by 15
Self-citation
Pain and multiple facets of anger and hostility in a sample seeking treatment for problematic anger
McDermott, K. A., Smith, H. L., Matheny, N. L., & Cougle, J. R. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.04.006 · Cited by 15
Global Chronic Pain
Ho, A., & Nair, S. (2018) · Developments in neuroethics and bioethics · doi:10.1016/bs.dnb.2018.08.009 · Cited by 15
Are individuals with orofacial pain more prone to psychological distress during the COVID-19 pandemic?
Saki, M., Shadmanpour, M., & Najafi, H. Z. (2021) · Dental and Medical Problems · doi:10.17219/dmp/131683 · Cited by 15
The associations of chronic pain and 24-h movement behaviors with incident mental disorders: evidence from a large-scale cohort study
Chen, J., Fang, X., Zhang, F., Shen, J., Liu, Y., Xu, P., Ye, R., Zhong, Q., Chen, G., Wang, Z., et al. (2024) · BMC Medicine · doi:10.1186/s12916-024-03534-5 · Cited by 15
“A meta-analysis suggested patients with chronic pain are more likely to develop psychological problems such as depression, anxiety, and phobias [48].”
Background
Randomized controlled trial investigating the effectiveness of a multimodal mobile application for the treatment of chronic pain
Thomson, C. J., Pahl, H., & Giles, L. V. (2024) · Canadian Journal of Pain · doi:10.1080/24740527.2024.2352399 · Cited by 13
Impact of a nurse‐led intervention on quality of life in patients with chronic non‐malignant pain: An open randomized controlled trial
Morales‐Fernández, Á., Jiménez-Martín, J., Morales‐Asencio, J. M., Romero, M. V., Mora‐Banderas, A., Aranda‐Gallardo, M., & Canca‐Sánchez, J. C. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14608 · Cited by 19
Seeking treatment for temporomandibular disorders: What patients can expect from non-dental health care providers
Greene, C. S., & Bertagna, A. E. (2019) · Oral Surgery Oral Medicine Oral Pathology and Oral Radiology · doi:10.1016/j.oooo.2019.01.007 · Cited by 13
Network Alterations in Comorbid Chronic Pain and Opioid Addiction: An Exploratory Approach
Smallwood, R. F., Price, L. R., Campbell, J. L., Garrett, A. S., Atalla, S., Monroe, T. B., Aytur, S., Potter, J. S., & Robin, D. A. (2019) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2019.00174 · Cited by 13
The profile of musculoskeletal pain and its associations with sleep quality and depression during the COVID-19 in Turkey
Karatel, M., Bulut, Z. İ., Sarı, E. O., Pelin, Z., & Yakut, Y. (2021) · The Korean journal of pain · doi:10.3344/kjp.2022.35.1.78 · Cited by 13
“There is a relationship between anxiety, stress, and the inability to cope adequately with these difficult situations and pain [19,20].”
Background
Pain Beliefs and Quality of Life in Young People With Disabilities and Bothersome Pain
Miró, J., Solé, E., Gertz, K. J., Jensen, M. P., & Engel, J. M. (2017) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000482 · Cited by 12
Chronic pain: a consequence of dysregulated protective action
Hill, P. J. (2018) · British Journal of Pain · doi:10.1177/2049463718799784 · Cited by 12
The role of sleep quality on the relationship between posttraumatic stress symptoms and pain in women
Aaron, R. V., Noel, M. E., Dudeney, J. E., Wilson, A. C., Holley, A. L., & Palermo, T. M. (2019) · Journal of Behavioral Medicine · doi:10.1007/s10865-019-00016-5 · Cited by 13
Scrambler Therapy Treatment: The Importance of Examining Clinically Meaningful Improvements in Chronic Pain and Quality of Life
Nayback-Beebe, A. M., Panula, T., Arzola, S. M., & Goff, B. J. (2020) · Military Medicine · doi:10.1093/milmed/usz253 · Cited by 12
Multisite chronic pain: association with cognitive decline and post-mortem Alzheimer’s biomarkers
Bell, T. R., Franz, C. E., Lerman, I. R., Williams, M. E., Fennema‐Notestine, C., Panizzon, M. S., Elman, J. A., Bennett, D. A., & Kremen, W. S. (2025) · Brain Communications · doi:10.1093/braincomms/fcaf208 · Cited by 12
Self‐compassion predicting pain, depression and anger in people suffering from chronic pain: A prospective study
Emmerich, A. C., Friehs, T., Crombez, G., & Glombiewski, J. A. (2020) · European Journal of Pain · doi:10.1002/ejp.1638 · Cited by 14
“Prior research indicated that suffering from chronic pain is associated with low self-esteem (Burke et al., 2015).”
Background
Effectiveness of a Group-Based Rehabilitation Program Combining Education with Multimodal Exercises in the Treatment of Patients with Nonspecific Chronic Low Back Pain: A Retrospective Uncontrolled Study
Martins, C., Sayegh, S., Faundez, A., Fourchet, F., & Bothorel, H. (2022) · Biology · doi:10.3390/biology11101508 · Cited by 15
“Around 20 to 25% of LBP evolves from an acute episode towards a chronic status that is facilitated by multiple parameters such as psychosocial and physical factors as well as patient lifestyle and comorbidities [6,7].”
Background
Evidence of Widespread Mechanical Hyperalgesia but Not Exercise-Induced Analgesia in Athletes With Mild Patellar Tendinopathy Compared With Pain-Free Matched Controls
Plinsinga, M. L., Meeus, M., Brink, M. S., Heugen, N., & van Wilgen, P. (2020) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000001673 · Cited by 11
Follow-up of pregnancy-related carpal tunnel syndrome symptoms at 12 months postpartum: A prospective study
Meems, M., Truijens, S. E. M., Spek, V., Visser, L. H., & Pop, V. J. M. (2017) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2017.02.030 · Cited by 11
Alexithymia in a Chinese Patient with Chronic Pain and Associated Factors: A Cross-Sectional Study
Pei, J., Wang, X., Ma, T., Du, Y., & Dou, X. (2023) · Pain Management Nursing · doi:10.1016/j.pmn.2023.01.003 · Cited by 13
Mental disorder prevalence in chronic pain patients using opioid versus non‐opioid analgesics: A registry‐linkage study
Gjerde, L. C., Skurtveit, S. O., Handal, M., Nesvåg, R., Clausen, T., Lid, T. G., Hamina, A., Borchgrevink, P. C., & Odsbu, I. (2023) · European Journal of Pain · doi:10.1002/ejp.2121 · Cited by 10
“Chronic pain patients are more likely to experience a mental disorder compared to the general population (Burke et al., 2015; Velly & Mohit, 2018).”
BackgroundMethod

Authors: Burke, A. L. J., Mathias, J. L., & Denson, L. A.
Affiliations: Royal Adelaide Hospital (AU)
The University of Adelaide (AU)
Corresponding author: Burke, Anne L. J.
ORCID: Burke, Anne L. J.
Mathias, Jane L.
Denson, Linley A.
Venue: British Journal of Clinical Psychology
Publisher: Wiley
Published: 2015-03-13
Volume: 54
Issue: 3
Pages: 345-360
ISSN: 0144-6657 (ISSN-L)
2044-8260
DOI: 10.1111/bjc.12078
OpenAlex: W2082947525
Cited by: 239
References: 46
Citations by year: 2026: 16 · 2025: 28 · 2024: 20 · 2023: 27 · 2022: 21 · 2021: 20 · 2020: 25 · 2019: 25 · 2018: 21 · 2017: 19 · 2016: 13 · 2015: 4
FWCI: 2.38
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: British Journal of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Funders: American Psychological Association
Cilag
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords: chronic pain, psychological functioning, depression, anxiety, somatization, anger, hostility, self-efficacy, self-esteem, emotional functioning, pain-related anxiety, fear of pain, psychological comorbidity
MeSH terms: Adult, Anger, Anxiety, Depression, Fear, Female, Hostility, Humans, Male, Middle Aged, Quality of Life, Self Concept, Somatoform Disorders, Stress, Psychological, Databases, Factual, Self Efficacy, Chronic Pain

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Psychological functioning of people living with chronic pain: a meta-analytic review

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