{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:17:47Z","timestamp":1788445067425,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Graded Chronic Pain Scale\u2010Revised (GCPS\u2010R) enables a standardised measure of chronic pain severity. Only sparse data are available on the prevalence of chronic pain stages assessed by the GCPS\u2010R and the predictors of high\u2010impact chronic pain (HICP) in the general European population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional cohort study surveyed 2498 people \u2265\u200916\u2009years living in Germany in 2025. Self\u2010reported measures were obtained for demographic variables, chronic pain stages and disease load (Patient Health Questionnaire 4 and chronic illness). Potential predictors of HICP (age, gender, education, net income, probable depressive and anxiety disorder, chronic illness) compared to no and mild\u2010impact and to bothersome chronic pain were assessed by adjusted univariate and multivariate logistic regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Response rate was 37.9%. The prevalence of chronic pain present most or every day prior to 3\u2009months was 11.4 (95% CI, 7.7% to 15.1%) of which 1.1% (\u22122.9% to 5.0%) with mild impact chronic pain; 3.3% (\u22120.6% to 7.2%) with bothersome impact chronic pain; and 7.1% (3.3% to 10.9%) with HICP. HICP compared to no and mild chronic pain was predicted in multivariate\u2010adjusted analysis by age, lower educational level, lower income, probable anxiety and\/or depressive disorder and chronic illness. Multivariate\u2010adjusted analysis did not show significant associations of HICP with the selected variables when compared to bothersome pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Biological, psychological and social factors are associated with HICP. Targeted pain services for populations at highest risk for HICP need to be developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>The prevalence of bothersome and high\u2010impact chronic pain rather than prevalence rates of any chronic pain might provide evidence in support of pain specialist care. Identifying risk factors of high\u2010impact chronic pain in specific populations could lead to an improved understanding of the risk factors, causes and consequences of chronic pain. European public health policies could be influenced by gathering data on high\u2010impact chronic pain in other European countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70229","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T08:09:14Z","timestamp":1769846954000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and Predictors of High\u2010Impact Chronic Pain in the General German Population"],"prefix":"10.1002","volume":"30","author":[{"given":"Patric","family":"Bialas","sequence":"first","affiliation":[{"name":"Department Anesthesiology, Intensive Care and Pain Medicine, Saarland University Medical Center  Homburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Tesarz","sequence":"additional","affiliation":[{"name":"Clinic for Psychosomatic Medicine and Psychotherapy University Medical Center Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar","family":"Br\u00e4hler","sequence":"additional","affiliation":[{"name":"Clinic for Psychosomatic Medicine and Psychotherapy University Medical Center Johannes Gutenberg University Mainz  Mainz Germany"},{"name":"Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy Rostock University Medical Center  Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Muschalla","sequence":"additional","affiliation":[{"name":"Department of Psychotherapy and Diagnostics Technische Universit\u00e4t Braunschweig  Braunschweig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Zenger","sequence":"additional","affiliation":[{"name":"Faculty of Applied Human Studies University of Applied Sciences Magdeburg and Stendal  Stendal Germany"},{"name":"Integrated Research and Treatment Center Adiposity Diseases \u2010 Behavioral Medicine, Psychosomatic Medicine and Psychotherapy University of Leipzig Medical Center  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjarne","family":"Schmalbach","sequence":"additional","affiliation":[{"name":"Medical Psychology &amp; Medical Sociology University Medical Center of the Johannes Gutenberg\u2010University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3742-729X","authenticated-orcid":false,"given":"Winfried","family":"H\u00e4user","sequence":"additional","affiliation":[{"name":"Clinic for Psychosomatic Medicine and Psychotherapy University Medical Center Johannes Gutenberg University Mainz  Mainz Germany"},{"name":"Department Psychosomatic Medicine and Psychotherapy Technical University Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"ADM.2024.\u201cThe ADM Sampling System\u2014The Reference System for Representative Studies in Germany.\u201dhttps:\/\/www.adm\u2010ev.de\/en\/member\u2010services\/the\u2010adm\u2010sampling\u2010system\/."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/135910457000100301"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)00393\u20107"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6736a2"},{"key":"e_1_2_11_6_1","unstructured":"European Commission Eurostat.2018.\u201cEuropean Health Interview Survey (EHIS Wave 3)\u2014Methodological Manual.\u201d European Commission 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