Hamed SA, Hamed EA, Fawzy M. Chronic musculoskeletal pain disorder and its associated mental health conditions, comorbidities and psychosocial risk predictors. World J Clin Cases 2026; 14(15): 120217 [DOI: 10.12998/wjcc.v14.i15.120217]
Corresponding Author of This Article
Sherifa Ahmed Hamed, MD, Professor, Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospitals, Assiut University Mall, Assiut 71516, Assiut, Egypt. hamedsherifa@aun.edu.eg
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Psychiatry
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Observational Study
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May 26, 2026 (publication date) through May 12, 2026
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Publication Name
World Journal of Clinical Cases
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2307-8960
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Hamed SA, Hamed EA, Fawzy M. Chronic musculoskeletal pain disorder and its associated mental health conditions, comorbidities and psychosocial risk predictors. World J Clin Cases 2026; 14(15): 120217 [DOI: 10.12998/wjcc.v14.i15.120217]
World J Clin Cases. May 26, 2026; 14(15): 120217 Published online May 26, 2026. doi: 10.12998/wjcc.v14.i15.120217
Chronic musculoskeletal pain disorder and its associated mental health conditions, comorbidities and psychosocial risk predictors
Sherifa Ahmed Hamed, Eman Ahmed Hamed, Mohamed Fawzy
Sherifa Ahmed Hamed, Mohamed Fawzy, Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospitals, Assiut 71516, Assiut, Egypt
Eman Ahmed Hamed, Department of Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University, Assiut 71516, Assiut, Egypt
Author contributions: Hamed SA designed the study, conducted data collection and neurological evaluations of the patients, administered diagnostic questionnaires, and contributed to statistical analyses and manuscript drafting; Hamed EA conducted rheumatologic evaluation and participated in data acquisition and analysis; Fawzy M conducted psychiatric interviews, participated in data acquisition, analysis, and interpretation; Hamed EA and Fawzy M critically revised the article for important intellectual content.
Institutional review board statement: The study protocol adhered to the Helsinki Declaration and received approval from the local Ethics Committee of the Faculty of Medicine, Assiut University, Assiut, Egypt (No. AU-CMP-000264_2022).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement:
Data can be available upon reasonable request.
Corresponding author: Sherifa Ahmed Hamed, MD, Professor, Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospitals, Assiut University Mall, Assiut 71516, Assiut, Egypt. hamedsherifa@aun.edu.eg
Received: February 24, 2026 Revised: March 13, 2026 Accepted: April 8, 2026 Published online: May 26, 2026 Processing time: 82 Days and 6.3 Hours
Abstract
BACKGROUND
Chronic musculoskeletal pain (CMP) is a functional neurological symptom that manifests as real pain originating from the brain due to mental health issues and a combination of factors.
AIM
To determine the patterns of CMP, the associated emotional, behavioral and social components and predictors of pain’s impact on daily life.
METHODS
This cross-sectional study included 160 patients with CMP (males = 30; females = 130). Data collection included demographics and clinical features of pain. Pain severity was measured using the Visual Analog Scale questionnaire. Psychiatric evaluation included psychiatric interviewing and psychometric questionnaires. They included Depression Anxiety Stress Scale, Insomnia Severity Index, Fatigue Severity Scale, Life Stressors, Brief Cope Inventory, and World Health Organization quality of life (WHOQOL).
RESULTS
Patients had mean age of 46.63 ± 6.23 years and mean duration of pain of 16.28 ± 3.05 months. Localized pain was more common (78%, n = 125) than diffuse (fibromyalgia) (22%, n = 35), with low back pain being the most frequent localized pain (30.4%). Approximately 37.5% (n = 60) had major depression and 43.75% (n = 70) had anxiety disorder. Patients had high scores and frequencies of depression, anxiety, and stress symptoms, insomnia fatigue and poor WHOQOL scores. Life stressors were reported in 60%-75%. Maladaptive copying strategies to pain were reported in 45%-60%. Multiple regression analysis showed that factors associated with low scores of physical domain of WHOQOL included duration of pain (β = 1.426; 95%CI: 0.565-3.428; P < 0.01), symptoms of depression (β = 2.356; 95%CI: 1.564-4.842; P < 0.01), anxiety (β = 1.232; 95%CI: 0.863-4.680; P < 0.01) and stress (β = 2.346; 95%CI: 1.620–6.550; P < 0.001), insomnia (β = 1.843; 95%CI: 1.648-3.642; P < 0.01) and low scores of psychological (β = 6.7; 95%CI: 2.30-8.640, P < 0.001) and social domains (β = 3.5; 95%CI: 5-12, P < 0.001) of WHOQOL.
CONCLUSION
CMP is more frequent in middle aged females than males. It is associated with emotional and behavioral abnormalities and resulted in impaired quality of life. It is due to central processing alterations influenced by psychosocial issues. Understanding the factors associated with CMP and prolonged disability, including mental health, is crucial for developing effective treatment strategies.
Core Tip: Chronic musculoskeletal pain (CMP) is a common condition affecting 20%-30% of adults worldwide, with a higher prevalence in females. It manifests as persistent pain in muscles, bones, joints, tendons, or ligaments lasting over three months. CMP is a complex issue with medical, psychological, and psychosocial risk factors. It is also known as psychogenic musculoskeletal pain. Diagnosis of CMP requires a comprehensive evaluation by specialists and diagnostic tests. Treatment options include medications, physiotherapy, and psychotherapy. Researchers suggest that psychogenic pain involves intricate neurobiological and biopsychosocial elements. Cultural considerations in pain reporting and expression are essential in managing patients with CMP.
