The Burden of Chronic Pain in College Students: Associations with Mental Health, Cognition, and Functional Outcomes

Chronic pain in college students is an underrecognized contributor to impairments in mental health, cognitive function, and daily functioning, yet few studies evaluate these domains together. This study examined associations between chronic pain and functional outcomes in 983 undergraduate students. Participants completed self-report measures assessing pain presence and intensity, treatment use, depressive symptoms, cognitive function, and quality of life across physical, social, and psychosocial domains. Nearly one-quarter reported chronic pain, primarily musculoskeletal, yet only 24% received treatment. Compared with pain-free peers, students with chronic pain demonstrated lower quality of life, greater cognitive difficulties, and higher depressive symptom severity, with a 68% increased likelihood of clinically significant cognitive impairment and 7.61-fold higher odds of severe depressive symptoms. Functional deficits were most pronounced in physical and social domains, affecting daily activities and campus engagement. Exploratory analyses indicated trending interactions among depressive symptoms, cognition, and quality of life in predicting pain burden, highlighting its multidimensional nature. Notably, current treatment approaches were not associated with reduced pain or improved functioning. These findings emphasize the need for integrated, accessible interventions in higher education that target psychological well-being, cognitive resilience, and social and physical functioning to optimize academic performance, quality of life, and overall student health.