OBJECTIVES: The prevalence of pain and mental health conditions are increasing in the United States (US). Individuals with pain are at risk for mental health problems. This study investigated the association between pain severity and self-perceived poor mental health status among US adults.

METHODS: This retrospective, cross-sectional study included participants from the Medical Expenditure Panel Survey 2019 full-year consolidated data file who were ≥18 years, alive for the full calendar year, and had data available for pain status. Hierarchical logistical regression analysis assessed statistically significant associations between pain severity and other confounding variables with poor perceived mental health status. The a priori alpha level was 0.05.

RESULTS: The weighted population was 242,169,897 US adults (poor/fair mental health=20,327,445, good/very good/excellent mental health=221,842,452). Greater levels of pain severity were associated with greater odds of reporting poor perceived mental health. Additionally, several other variables were associated with reporting poor perceived mental health including: age ≥65 and 40-64 versus 18-39 (adjusted odds ratio [AOR]=0.4 95% confidence interval [CI]=0.3%-0.5%), white versus other race (AOR=1.3 95% CI=1.1%-1.6%), married versus other marital status (AOR=0.7 95% CI=0.6%-0.8%), poor/near poor/low versus moderate/high income (AOR=1.3 95% CI=1.1%-1.5%), employed versus unemployed employment status, (AOR=0.8 95% CI=0.7%-1.0%), public versus uninsured health insurance (AOR=1.5 95% CI=1.1-2.0), instrumental activities of daily living limitation yes versus no (AOR=1.8 95% CI=1.3%-2.4%), activities of daily living limitation yes versus no (AOR=1.8 95% CI=1.3%-2.6%), ≥2 versus <2 chronic conditions (AOR=1.3 95% CI=1.0%-1.6%), perceived physical health status excellent/very good/good versus fair/poor (AOR=0.1 95% CI=0.1%-0.1%), regular exercise versus no regular exercise (AOR=0.7 95% CI=0.6%-0.8%), and smoker versus non-smoker (AOR=1.3 95% CI=1.1%-1.6%).

CONCLUSIONS: Pain severity and other variables were significantly associated with reporting poor perceived mental health among US adults. These findings may be important to implement multidomain pain and mental health care strategies to improve health outcomes for patients.