Non-Cochrane · aetiology · PM42052223
Sex Differences and Psychological Assessments in Chronic Pain: A Systematic Review and Meta-Analysis.
Sudharta Harvey, Putra Marson, Suswanti Ika, et al. · Clinical neuropsychiatry · 2026 · PubMed · doi:10.36131/cnfioritieditore20260207
Findings
21 findings
| Population | ||||
|---|---|---|---|---|
| Adults with chronic pain | Female sex | Male sex | Anxiety score Sensitivity: leave-one-out, omitting Edwards 2003 | SMD -0.10 [-0.20, -0.01] GRADE not reported 3 studies |
| Adults with chronic pain | Female sex | Male sex | Depression score (HADS-D) Subgroup: HADS-D only | SMD -0.12 [-0.22, -0.02] GRADE not reported 2 studies · 1771 participants |
| Adults with chronic pain | Female sex | Male sex | Depression score Sensitivity: leave-one-out, omitting Ramirez-Maestre 2014 | SMD 0.18 [-0.05, 0.40] GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Depression score Sensitivity: leave-one-out, omitting Edwards 2003 | SMD 0.14 [-0.07, 0.35] GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Depression score Sensitivity: leave-one-out, omitting Heinberg 2004 (low back pain) | SMD 0.16 [-0.05, 0.36] GRADE not reported Studies not reported |
| Adults with chronic pain (cross-sectional studies) | Female sex | Male sex | Anxiety and depression symptom scores (outcome not specified) Pain category: Musculoskeletal chronic pain Unresolved: the two extractors disagree on this row. | Subgroup analysis yielded no significant findings (no numeric estimate reported) GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Anxiety score Overall pooled (all anxiety tools) | SMD -0.10 [-0.19, -0.01] Low 4 studies · 2105 participants |
| Adults with chronic pain | Female sex | Male sex | Anxiety score Sensitivity: leave-one-out, omitting Rovner 2017 | SMD -0.13 [-0.27, 0.02] GRADE not reported 3 studies |
| Adults with chronic pain | Female sex | Male sex | Anxiety score Sensitivity: leave-one-out, omitting Ramirez-Maestre 2014 | SMD -0.11 [-0.21, -0.01] GRADE not reported 3 studies |
| Adults with chronic pain (cross-sectional studies) | Female sex | Male sex | Anxiety and depression symptom scores (outcome not specified) Pain category: Non-specific chronic pain Unresolved: the two extractors disagree on this row. | Subgroup analysis yielded no significant findings (no numeric estimate reported) GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Depression score Sensitivity: leave-one-out, omitting Harris 2008 | SMD 0.16 [-0.08, 0.39] GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Depression score Overall pooled (all depression tools) | SMD 0.13 [-0.07, 0.32] GRADE not reported 8 studies · 3003 participants |
| Adults with chronic pain | Female sex | Male sex | Depression score Sensitivity: leave-one-out, omitting Adams 2008 | SMD 0.07 [-0.12, 0.25] GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Depression score Sensitivity: leave-one-out, omitting Keogh 2005 | SMD 0.16 [-0.07, 0.38] GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Anxiety score Sensitivity: leave-one-out, omitting Keogh 2005 | SMD -0.07 [-0.16, 0.03] GRADE not reported 3 studies |
| Adults with chronic pain | Female sex | Male sex | Depression score Sensitivity: leave-one-out, omitting Heinberg 2004 (second entry, also labeled low back pain in Table 6) | SMD 0.07 [-0.11, 0.25] GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Depression score (BDI/BDI-II) Subgroup: BDI/BDI-II only | SMD 0.24 [-0.02, 0.51] GRADE not reported 6 studies · 1232 participants |
| Adults with chronic pain | Female sex | Male sex | Depression score Sensitivity: leave-one-out, omitting Fillingim 2003 | SMD 0.05 [-0.12, 0.22] GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Depression score Sensitivity: leave-one-out, omitting Rovner 2017 | SMD 0.18 [-0.06, 0.42] GRADE not reported Studies not reported |
| Adults with chronic pain (cross-sectional studies) | Female sex | Male sex | Anxiety and depression symptom scores (outcome not specified) Pain category: Spinal/low-back chronic pain Unresolved: the two extractors disagree on this row. | Subgroup analysis yielded no significant findings (no numeric estimate reported) GRADE not reported Studies not reported |
| Adults with chronic pain | Female sex | Male sex | Sleep disturbance scores | We found no studies comparing sleep disturbances between sexes in chronic pain populations. No studies found 0 studies |
Included primary studies 17
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Adams 2008 Depression Augments Activity‐Related Pain in Women but not in Men with Chronic Musculoskeletal Conditions DOI:10.1155/2008/963216 | 2008 | this review only | Anxiety and depression symptom scores (outcome not specified) | not extracted yet |
| Adams 2008 Depression augments activity-related pain in women but not in men with chronic musculoskeletal conditions. PMID:18592061 | 2008 | this review only | not stated | not extracted yet |
| Canales 2019 Distribution of depression, somatization and pain-related impairment in patients with chronic temporomandibular disorders DOI:10.1590/1678-7757-2018-0210 | 2019 | this review only | not stated | not extracted yet |
| Canales 2019 Distribution of depression, somatization and pain-related impairment in patients with chronic temporomandibular disorders. PMID:30624469 | 2019 | this review only | not stated | not extracted yet |
| Edwards 2003 Differential Relationships Between Anxiety and Treatment-Associated Pain Reduction Among Male and Female Chronic Pain Patients DOI:10.1097/00002508-200307000-00003 | 2003 | this review only | Anxiety score; Anxiety and depression symptom scores (outcome not specified) | not extracted yet |
| Edwards 2003 Differential relationships between anxiety and treatment-associated pain reduction among male and female chronic pain patients. PMID:12840614 | 2003 | this review only | not stated | not extracted yet |
| Fillingim 2003 Clinical Characteristics of Chronic Back Pain as a Function of Gender and Oral Opioid Use DOI:10.1097/00007632-200301150-00010 | 2003 | this review only | Anxiety and depression symptom scores (outcome not specified) | not extracted yet |
| Fillingim 2003 Clinical characteristics of chronic back pain as a function of gender and oral opioid use. PMID:12544931 | 2003 | this review only | not stated | not extracted yet |
| Harris 2008 Psychometric properties of the Beck Depression Inventory--second edition (BDI-II) in individuals with chronic pain. PMID:18079063 | 2008 | this review only | Anxiety and depression symptom scores (outcome not specified) | not extracted yet |
| Heinberg 2004 Psychological factors in pelvic/urogenital pain: the influence of site of pain versus sex DOI:10.1016/j.pain.2003.12.007 | 2004 | this review only | Anxiety and depression symptom scores (outcome not specified) | not extracted yet |
| Heinberg 2004 Psychological factors in pelvic/urogenital pain: the influence of site of pain versus sex. PMID:15109511 | 2004 | this review only | not stated | not extracted yet |
| Keogh 2005 Gender moderates the association between depression and disability in chronic pain patients DOI:10.1016/j.ejpain.2005.05.007 | 2006 | this review only | Anxiety score; Anxiety and depression symptom scores (outcome not specified) | not extracted yet |
| Keogh 2005 Gender moderates the association between depression and disability in chronic pain patients. PMID:16009583 | 2006 | this review only | not stated | not extracted yet |
| Ramirez-Maestre 2014 The Role of Sex/Gender in the Experience of Pain: Resilience, Fear, and Acceptance as Central Variables in the Adjustment of Men and Women… DOI:10.1016/j.jpain.2014.02.006 | 2014 | this review only | Anxiety score; Anxiety and depression symptom scores (outcome not specified) | not extracted yet |
| Ramirez-Maestre 2014 The role of sex/gender in the experience of pain: resilience, fear, and acceptance as central variables in the adjustment of men and women… PMID:24632112 | 2014 | this review only | not stated | not extracted yet |
| Rovner 2017 Chronic pain and sex-differences; women accept and move, while men feel blue DOI:10.1371/journal.pone.0175737 | 2017 | this review only | Anxiety score; Anxiety and depression symptom scores (outcome not specified) | not extracted yet |
| Rovner 2017 Chronic pain and sex-differences; women accept and move, while men feel blue. PMID:28441403 | 2017 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Human chronic pain population (non-acute, non-subacute); malignant and non-malignant chronic pain | Adults with chronic pain, 9 cross-sectional studies (3,003 participants in meta-analysis of 8 studies); non-specific, musculoskeletal, spinal, low-back, TMD and urogenital pain |
| Intervention | Female sex (exposure) | Female sex |
| Comparison | Male sex | Male sex |
| Outcomes | Psychological assessment scores: depression, anxiety, sleep disorders | Anxiety (4 studies, n=2,105); depression (8 studies, n=3,003); no studies on sleep disturbance |
| Study designs | Human cross-sectional studies | Cross-sectional studies (n=9) |
| Timing | Not specified | Not specified |