Chronic neck pain as an exacerbating factor for depressive symptoms in a 1-Year longitudinal population study

Abstract

Chronic neck pain is linked to depression, but its long-term effects on depressive symptoms remain unclear. This study examined the impact of chronic neck pain on depressive symptoms over 1 year in individuals with mild depression or moderate-to-severe depression using data from the Circannual Change in Headache and Sleep (CHASE) study, a nationally representative Korean cohort. Among 1,551 participants, depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) across five assessments over 1 year. Chronic neck pain was defined as persistent neck pain at all assessments. Covariates, including anxiety, sleep quality, and lifestyle factors, were adjusted for in the analyses to account for potential confounders. Chronic neck pain was reported by 19% of participants with mild depression (n = 721) and 36.1% of those with moderate-to-severe depression (n = 108). At baseline, these participants had poorer sleep quality, greater insomnia severity, and a higher symptom burden. Over 1 year, chronic neck pain was associated with greater increases in PHQ-9 scores, particularly in sleep disturbances, fatigue, and concentration difficulties, despite overall symptom improvement. In conclusion, chronic neck pain exacerbates depressive symptoms over time, especially in sleep-related and physical domains, highlighting the need for integrated treatment approaches addressing both conditions.