ADHD Traits Linked to Higher Chronic Pain Severity in Japanese Patients

Researchers at the University of Tokyo Hospital examined nearly 1,000 patients with severe chronic pain at specialized pain centers across Japan. They reported that ADHD-related traits occurred 2.4 times more often than in the general population and were positively associated with greater pain intensity, anxiety, depression, and maladaptive pain cognitions.

ADHD and chronic pain, an overlooked connection

Chronic pain, defined as pain persisting beyond normal tissue healing, affects millions worldwide and often resists standard treatments. Emerging evidence suggests that neurodevelopmental conditions such as ADHD may shape pain perception and treatment response.

ADHD and chronic pain, an overlooked connection

The cross-sectional study screened participants for ADHD- and autism-related traits using validated questionnaires and correlated trait prevalence with self-reported pain severity and psychological measures. Approximately 1,000 patients were included; ADHD-related traits were 2.4 times more prevalent than population norms and showed a positive correlation with pain scores and with anxiety and depression scales.

ADHD and chronic pain, an overlooked connection

Dr. Satoshi Kasahara noted that routine clinical encounters often reveal ADHD-like inattentiveness, hyperactivity, impulsivity, and emotional-regulation difficulties among chronic-pain patients, traits that are frequently undiagnosed. He argued that comprehensive, multimodal care—combining medical, psychological, and rehabilitative approaches—could better address pain in patients with these traits.

ADHD and chronic pain, an overlooked connection

The association suggests that screening for ADHD traits could inform treatment planning. Integrating cognitive-behavioral therapy, exercise-based rehabilitation, and psychoeducation may mitigate anxiety, depression, and maladaptive pain thoughts, potentially enhancing outcomes beyond medication alone.

ADHD and chronic pain, an overlooked connection

• “In our latest study, we looked at patients with severe chronic pain who were being treated at specialized pain centers across Japan, and examined how often ADHD- and autism-related traits were present in this population,” — Dr. Satoshi Kasahara, Department of Anesthesiology and Pain Relief Center, University of Tokyo Hospital

ADHD and chronic pain, an overlooked connection

• “We found that ADHD-related traits were more common in these patients than in the general population, about 2.4 times higher. These traits were also closely linked to pain severity, as well as to psychological factors such as anxiety, depression and negative ways of thinking about pain.” — Dr. Satoshi Kasahara

ADHD and chronic pain, an overlooked connection

• “This research began from everyday clinical experience. In our practice, we frequently encounter patients with chronic pain who do not respond well to conventional treatments. Among these patients, many show characteristics commonly seen in ADHD, such as inattention, hyperactivity or impulsivity, and difficulties with emotional regulation,” — Dr. Satoshi Kasahara

ADHD and chronic pain, an overlooked connection

• “In such cases, psychoeducation, helping patients understand their own characteristics and learn how to better manage their behavior, can also play an important role.” — Dr. Satoshi Kasahara

ADHD and chronic pain, an overlooked connection

The cross-sectional design precludes causal inference, and broader validation in diverse populations is needed.

ADHD and chronic pain, an overlooked connection

The researchers plan prospective, interventional trials to test systematic ADHD screening and tailored multimodal care for chronic-pain patients.

ADHD and chronic pain, an overlooked connection