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Sex Differences and Psychological Assessments in Chronic Pain: A Systematic Review and Meta-Analysis
Harvey Sudharta1, Marson Putra1, Ika Suswanti2
1Atma Jaya Neuroscience and Cognitive Center, Department of Neurology, School of Medicine and Health Science, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
Clinical Neuropsychiatry
|April 29, 2026
Summary
Females with chronic pain reported lower anxiety scores than males, but depression levels were similar. This highlights the need for unbiased mental health care for males with chronic pain, as their experiences may be underrecognized.
Area of Science:
- Psychiatry and Psychology
- Pain Management
- Sex Differences in Health
Background:
- Mental illnesses and chronic pain often coexist, creating a cycle of disability.
- Existing research on sex differences in chronic pain and mental health is conflicting.
- Understanding these differences is crucial for effective, unbiased treatment.
Purpose of the Study:
- To systematically review and meta-analyze psychological assessment scores across sexes in chronic pain populations.
- To clarify the association between psychological test results and sex differences in chronic pain.
- To address existing sex biases in chronic pain research.
Main Methods:
- Systematic review and meta-analysis of studies from PubMed, ScienceDirect, ProQuest, and EBSCOhost.
- Inclusion of nine high-quality cross-sectional studies (3,003 participants).
- Standardized Mean Differences (SMD) with 95% confidence intervals (CI) were used to analyze data.
Main Results:
- Females with chronic pain exhibited significantly lower anxiety scores (SMD -0.10, p=0.03).
- No significant sex differences were found in depression scores among individuals with chronic pain (SMD 0.13, p=0.20).
- All included studies were rated as high quality using the Joanna Briggs Institute (JBI) tool.
Conclusions:
- Females with chronic pain show lower anxiety compared to males, with similar depression levels.
- There is a need for unbiased mental health care that addresses the pain experience in males with chronic pain.
- Male mental health experiences in chronic pain populations may be underrecognized and require further attention.
