# Correlation between attention deficit/hyperactivity disorder and chronic pain: a survey of adults in Japan

## TL;DR

This study found that ADHD symptoms are strongly linked to chronic pain in adults in Japan, more so than mental health issues or autism symptoms.

## Contribution

The study reveals a novel association between ADHD symptoms and chronic pain severity, suggesting ADHD screening for chronic pain patients.

## Key findings

- ADHD symptoms were more strongly associated with chronic pain than mental health problems.
- ADHD symptoms showed a stronger link to chronic pain intensity compared to ASD symptoms.
- ADHD medication may help alleviate coexisting chronic pain, highlighting the importance of ADHD screening in chronic pain patients.

## Abstract

This cross-sectional epidemiological internet survey assessed whether attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) symptoms are associated with pain chronicity and intensity and explored the relationship between developmental disorder symptoms and pain. Participants were 4028 adults aged 20–64 years who experienced pain, assessed using an 11-point numerical rating scale (NRS), in any body part in the previous 4 weeks. ADHD and ASD symptoms were assessed using the Adult ADHD Self-Report Scale (ASRS) and autism spectrum quotient, respectively. Problems with mental health (PMH) were assessed using the shortened Profile of Mood States. Pathway analyses were performed to examine the association between ADHD symptoms and pain. The chronic pain symptoms (CP) group (N = 1465) scored higher than the non-CP group (N = 2563) for all ASRS variables. ASRS positivity was associated with CP symptoms and increased with increasing NRS score; the CP group showed particularly high positivity (38.3%) with extreme pain. ADHD symptoms were more strongly associated with CP symptoms and intensity than was PMH (0.26 vs. 0.09). ADHD symptoms, but not ASD symptoms, were associated with CP symptoms. ADHD medications reportedly improve coexisting CP; therefore, ADHD screening and treatment may be important for patients with CP, especially those with extreme pain.

The online version contains supplementary material available at 10.1038/s41598-025-95864-4.