The Neuro-psychiatric Interface of Pain: Global Burden of Somatization-linked Neurological Disorders, 1990–2023
Salma Younas1, Aditya Jain2, Aditi Narsinghpura3, Abhigna Mallepally4, Sankranthi Sarath Chandra5, Sweta Sahu6
1University of the Punjab, 2Shyam Shah Medical College, Rewa, 3Kasturba Medical College, Mangalore, 4Gandhi Hospital, Hyderabad, 5Kurnool Medical College, 6JJM Medical College
Objective:
To estimate the global burden and temporal trends of psychiatric comorbidity within pain-linked neurological disorders using data from the Global Burden of Disease (GBD) 2023 study.
Background:
Pain-related neurological disorders frequently coexist with psychiatric comorbidities such as depression and anxiety, amplifying overall disability. Quantifying this overlap at the population level can inform integrative approaches to chronic pain management.
Design/Methods:
DALY (disability-adjusted life-year) rates per 100,000 population were extracted for headache disorders, depressive disorders, and anxiety disorders from 1990–2023. The “psychiatric overlay” was operationalized as the combined DALY rate of depression and anxiety relative to headache DALYs. Temporal trends and correlations were analyzed globally.
Results:
Between 1990 and 2023, global DALY rates increased by 69.5% for anxiety disorders and 46.3% for depressive disorders, versus 9.2% for headache disorders. The psychiatric overlay rose from approximately 120% in 1990 to 245% in 2023 (mean 180%). DALY trajectories for depression and headache were strongly correlated (r = 0.80), indicating parallel growth and potential shared etiological pathways.
Conclusions:
Psychiatric disorders now contribute more than twice the disability burden of headache disorders globally, underscoring the deep neuropsychiatric interconnection within chronic pain. Integrating mental health assessment and treatment into neurological care pathways may substantially reduce the overall burden of pain disorders worldwide.
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