Leader(s): Dr. Renée El-Gabalawy
Institution(s): University of Manitoba
Other Members: Dr. Brian Csupak, Dr. Eric Jacobsohn, Dr. Gordon Asmundson, Jordana Sommer, Elena Bilivicus

Why was the study done?
We conducted studies using population-based data to better understand the relationship between mental disorders and chronic pain conditions in terms of co-occurrence and how co-occurrence impacts people’s health. Research has historically focused largely on depression and chronic pain conditions, and we aimed to extend this research with a specific focus on anxiety disorders, particularly generalized anxiety disorder, and post-traumatic stress disorder. We examined the impact of co-occurrence on suicide, substance misuse, and chronic pain severity/disability. By understanding the complex relationship between mental and physical health, we are in a better position to create targeted interventions.


How was the study done?
We used large population-based datasets that included tens of thousands Canadians and Americans. Using large epidemiological samples, we are able to examine trends in samples that are considered nationally representative (data that is representative of the population of interest). These surveys were previously collected, and we analyzed the data using sophisticated statistical approaches.


What were the study results?We have published a large number of studies within this larger project. A few key findings are summarized here. Across studies, results indicated that anxiety disorders and post-traumatic stress disorder co-occur with chronic pain conditions at elevated rates. The co-occurrence of generalized anxiety disorder and chronic pain conditions can increase levels of disability, suicidal thoughts and behavior, and non-medical opioid use compared to the presence of conditions alone. Individuals with migraines and co-occurring generalized anxiety disorder may be at higher risk of maladaptive health outcomes. Social support and positive mental health may be protective for some of these outcomes.

Recent Updates:

Several papers resulting from this research have now been published, as well as posters presented at scientific conferences. 

Last updated: January 2021

Selected Publications:
  • Sommer, J. L., El-Gabalawy, R., Taillieu, T., Afifi, T. O., & Carleton, N (in press). Associations between trauma exposure and physical conditions among public safety personnel. Canadian Journal of Psychiatry.
  • Bilevicius, E., Sommer, J. L., Keough, M. & El-Gabalawy, R (in press). An examination of comorbid generalized anxiety disorder and chronic pain on substance misuse in a Canadian population-based survey. Canadian Journal of Psychiatry.
  • Bilevicius, E., Sommer, J. L., Asmundson, G. J. G., & El-Gabalawy, R. (2019) Associations of PTSD, chronic pain, and their comorbidity on cannabis use disorder: Results from an American nationally representative study. Depression and Anxiety, 36(11), 1036-1046. doi: 10.1002/da.22947
  • Sommer, J. L., Blaney, C. & El-Gabalawy, R (2019). A population-based examination of suicidality in comorbid generalized anxiety disorder and chronic pain. Journal of Affective Disorders, 257(1), 562-567. doi: https://doi-org.uml.idm.oclc.org/10.1016/j.jad.2019.07.016
  • Kaster, T., Sommer, J. L., Mota, N., Sareen, J., & El-Gabalawy, R (2019). Post-traumatic stress and cancer: Findings from a cross-sectional nationally representative sample. Journal of Anxiety Disorders, 65, 11-18.doi: https://doi-org.uml.idm.oclc.org/10.1016/j.janxdis.2019.04.004
  • Sommer, J. L., Roy, R., Holens, P., & El-Gabalawy, R. (in press). Posttraumatic stress disorder and chronic pain in the military. In M. Incayawar, S. Maldonado-Bouchard, & M. R. Clark (Eds.), Overlapping pain and psychiatric syndromes: Global perspectives. Oxford University Press.