Fibromyalgia Creates High Global Burden of Depression and Anxiety
A new systematic review and meta-analysis in the Journal of Affective Disorders reveals that nearly half of patients with fibromyalgia worldwide experience clinically relevant symptoms of depression and anxiety. The comprehensive study synthesizes data from observational research across multiple countries, providing clinicians with updated, evidence-based prevalence estimates to inform screening and management strategies.
Fibromyalgia, a chronic pain syndrome affecting an estimated 2–8% of the global population, has long been suspected of co-occurring with psychiatric symptoms, but the global prevalence of depression and anxiety in this population was previously unclear.
Study Findings
Researchers performed a systematic review and meta-analysis of peer-reviewed studies reporting prevalence rates of anxiety and depression among patients diagnosed with fibromyalgia. The team screened five major databases through January 2024 and applied rigorous quality assessments using standardized JBI checklists.
A total of 62 studies on anxiety (21,591 patients) and 88 studies on depression (31,104 patients) were included. Pooled estimates showed that 46.6% (95% CI: 39.2–54.0) of fibromyalgia patients experienced clinically significant anxiety, and 50.8% (95% CI: 45.5–56.1) had depression. Study heterogeneity was high (I² > 64%, p < 0.0001), reflecting variability in methods and populations across countries.
Importantly, the analysis identified age-related trends: anxiety prevalence declined with increasing age, while depression rates rose, a pattern that could have implications for age-targeted screening strategies. There was also significant variation among countries, underlining the influence of cultural, healthcare system, and socioeconomic factors on mental health burden in fibromyalgia.
Clinical Implications
These findings underscore that psychiatric comorbidity is not incidental but common in fibromyalgia, affecting roughly 1 in 2 patients. Clinicians treating individuals with fibromyalgia should maintain a high index of suspicion for mood and anxiety disorders and consider routine screening with validated tools such as the PHQ-9 or GAD-7 in primary care and rheumatology settings.
The age-related divergence in symptom patterns suggests that younger patients may warrant closer monitoring for anxiety disorders, while older patients might require enhanced depression surveillance. Given the interplay between mental health and chronic pain, untreated anxiety and depression can exacerbate pain perception, reduce function, lower quality of life, and complicate management of fibromyalgia symptoms.
Multidisciplinary care models incorporating mental health professionals, pain specialists, and primary clinicians may optimize outcomes by simultaneously addressing both somatic and psychological components of fibromyalgia.
Reference:
Jafari M, Zadgari E, M, et al. The global prevalence of depression and anxiety among fibromyalgia patients: A systematic review and meta-analysis. J Affect Disord. 2025. 2026; 393(A). doi:10.1016/j.jad.2025.120340
