Impact of lifestyle in chronic pain and depression a propensity score analysis in UK biobank

Hannah Casey*, Helen R. Wright, Josiah King, Mark J. Adams, Andrew M. McIntosh, Rona J. Strawbridge, Marie T. Fallon, Daniel J. Smith, Aja L. Murray, Heather C. Whalley

*Corresponding author for this work

Research output: Working paperPreprint

Abstract

Background

Chronic pain and depression are prevalent global health burdens that frequently co-occur, leading to worse outcomes than either condition alone. Current treatments are frequently inadequate, particularly for comorbid chronic pain and depression. Identifying contributing lifestyle factors could help inform more effective interventions and improve our understanding of disease pathophysiology.

Methods

This study aimed to identify contributing factors for both conditions by assessing the effects of seven lifestyle-related variables (using counterfactual analysis to account for confounding) within the UK Biobank. Chronic pain and depression were analysed as separate disorders and within nominal comorbidity groups (neither disorder, each disorder in isolation and both disorders combined), in full and sex-specific samples.

Results

Insufficient sleep (full sample: odds ratio (OR) =1.645, PAdjusted<0.001, female sample: OR=1.693, PAdjusted =0.002) and loneliness (full sample: OR=3.397, PAdjusted <0.001, female sample: OR=3.196, PAdjusted <0.001, male sample: OR=3.798, PAdjusted <0.001) were associated with increased risk of depression. Obesity (full sample: OR=1.379, PAdjusted<0.001, female sample: OR=1.467, PAdjusted<0.001, male sample: OR=1.308, PAdjusted= 0.005) was associated with an increased risk of chronic pain. In nominal outcomes, insufficient sleep (full sample: OR=1.828, PAdjusted <0.001, female sample: OR=1.845, PAdjusted<0.001, male sample: OR=1.847, PAdjusted=0.013) and loneliness (full sample: OR=3.488, PAdjusted<0.001, female sample: OR=3.388, PAdjusted<0.001, male sample: OR=3.782, PAdjusted<0.001) were associated with an increased risk of comorbid chronic pain and depression. Additionally, loneliness was also associated with an increased risk of depression without chronic pain (full sample: OR=2.812, PAdjusted =0.003, male sample: OR=3.467, PAdjusted=0.014) and obesity was associated with an increased risk of chronic pain without depression (full sample: OR=1.333, PAdjusted<0.001, female sample: OR=1.399, PAdjusted =0.002, male sample: OR=1.281, PAdjusted =0.018).

Conclusions

By identifying lifestyle-related risk factors with potential causal impacts on chronic pain, depression and their comorbidity, these findings enhance our understanding of disease pathophysiology and highlight potential markers and targets of more accurate diagnoses and non-therapeutic interventions.


Original languageEnglish
Pages318
Volume10
DOIs
Publication statusPublished - 18 Jun 2025

Publication series

NameWellcome Open Research
PublisherF1000 Research Ltd
ISSN (Print)2398-502X

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