慢性疼痛とADHD・ASD症状の関連を全国調査で解明―ADHD症状が痛みの重症化に強く関与―

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2026-04-23 東京大学

東京大学医学部附属病院の研究グループは、慢性疼痛患者958名を対象とした全国調査により、慢性疼痛と発達障害特性の関連を検証した。その結果、約2割に注意欠如・多動症や自閉スペクトラム症の症状が認められ、特にADHD症状が痛みの重症化と強く関係することが明らかになった。さらに、ADHD症状が不安・抑うつや「痛みの破局化」と相互に影響し、症状悪化につながる可能性が示唆された。本研究は、慢性疼痛の背景に心理・神経発達的要因が関与することを示し、診療における発達特性の評価の重要性を提示する。今後、個別化治療や医療政策の改善に貢献する知見と位置付けられる。

慢性疼痛とADHD・ASD症状の関連を全国調査で解明―ADHD症状が痛みの重症化に強く関与―
図1:痛みの強さとADHD・ASD陽性率の関係

<関連情報>

慢性疼痛における注意欠陥・多動性障害および自閉スペクトラム症:日本の疼痛センターにおける研究 Attention-deficit/hyperactivity disorder and autism spectrum disorder in chronic pain: a study in Japanese pain centers

Satoshi Kasahara,Shuichi Aono,Kozue Takatsuki,Shin-Ichi Niwa & Shoji Yabuki
Scientific Reports  Published:23 April 2026
DOI:https://doi.org/10.1038/s41598-026-45300-y

Abstract

Chronic pain is influenced by physical and psychosocial factors and associated with symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD); however, the specific symptom dimension related to pain severity and the underlying psychosocial pathways remain unclear. This cross-sectional screening study included 958 adult patients with persistent chronic pain despite standard care at their initial visit to multidisciplinary pain centers (Japan). Screening positivity rates were 17.1% for ADHD and 4.4% for ASD. ADHD symptoms, but not ASD symptoms, were considerably associated with higher pain intensity and extremely severe pain [average numerical rating scale score: 9–10]. Among patients with extremely severe pain, 27.4% were screened positive for ADHD. Hierarchical logistic regression analyses revealed that the association between ADHD symptoms and extremely severe pain was attenuated after adjustment for anxiety/depression and pain catastrophizing. Path analyses further indicated that ADHD symptoms were indirectly associated with severe chronic pain through anxiety/depression alone or through anxiety/depression combined with pain catastrophizing. Thus, ADHD symptoms are more strongly associated with pain severity than ASD symptoms in patients with persistent chronic pain, and emotional and cognitive factors may play a key mediating role. Screening for ADHD symptoms is crucial for comprehensive management of severe chronic pain.

医療・健康
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