OBJECTIVES: To identify and compare the health outcomes profiles of adults receiving medical care at specialty clinics for symptomatic (chronic pain) and largely asymptomatic (diabetes) chronic conditions. METHODS: Patients receiving care at pain or diabetes clinic completed the PROMIS-29 instrument that measures 7 health domains. Item response theory-based scores are on the T-metric with a mean of 50 and standard deviation (SD) of 10 based on the general United States population (norm). RESULTS: A total of 227 patients participated in the study (n=128 chronic pain; n=99 diabetes). The mean age was 46.7years (SD=13.7), 56% were women, 86.9% were non-Hispanic white, and 31.2% had <=12 years of education.  Pain clinic patients were significantly older and less educated than diabetes clinic patients, however there were no other demographic differences between patient groups. All 7 domain scores were statistically significantly worse for the chronic pain clinic patients compared with diabetes clinic patients (P<0.001 for all comparisons). The smallest and largest differences between clinics were observed for anxiety (mean difference=11.4) and pain interference (mean difference=22.0), respectively. Adjustment for age, sex, and education only slightly attenuated differences between the two patient populations. For example, the unadjusted mean difference between diagnostic groups for physical function was 17.7 (P<0.001), while the mean difference was 16.02 (P<0.001) when adjusted for demographic characteristics. The pain clinic sample had mean scores that were 0.9 to 1.7 SDs worse than the norm on all domains.  CONCLUSIONS: Compared with patients with diabetes, chronic pain clinic patients had a substantially poorer PROMIS-29 health outcome profile. Findings indicate that not only are health outcome profiles for chronic pain patients poor relative to the US population, but also poor relative to patients with a different chronic but relatively asymptomatic condition (diabetes) suggesting that aversive symptoms may have a more significant impact than chronic disease per se.