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Adults suffering with conditions including back pain and arthritis in Kent are much more likely to have depression or anxiety, new figures have shown.
A survey of patients registered with GPs in the county showed that 24% of those living with a musculoskeletal condition - those which affect joints, bones and muscles - were also living with depression and anxiety.
For all patients, the rate for the mental health conditions was 14%.
The Public Health England numbers show that, in Kent, one in six adults listed a musculoskeletal condition in the survey.
Arthritis and joint pain, which affected 13% of respondents, and back pain, which affected 11%, are the most common conditions.
Dr Sam Norton, from Arthritis Research UK, said: "Arthritis is painful and can rob someone of their independence, making it difficult to do things many of us take for granted - like going to work, getting dressed independently or meeting friends.
"In line with previous studies demonstrating increased rates of depression and anxiety in people with musculoskeletal conditions, the figures from Public Health England paint a picture of the toll that this pain and disability can take on a person's mental health."
Across the South East, 15% of people were affected by musculoskeletal conditions - lower than the England average of 17%.
"Arthritis is painful and can rob someone of their independence, making it difficult to do things many of us take for granted - like going to work, getting dressed independently or meeting friends..." - Dr Sam Norton, Arthritis Research UK
Of those, 22% said they also had depression or anxiety, compared to 13% for the population in the region as a whole.
Vicki Nash, from the mental health charity Mind, said that physical and mental health problems should be considered part of the same issue.
She said: "Living with a physical health condition such as a back problem or arthritis, especially if you are regularly in pain, can take its toll on a person's mental health, and it is understandable that being diagnosed and living with a chronic illness will have an impact on someone's mental wellbeing.
"Health professionals should treat each person as a whole and, if supporting someone with a physical health condition, offer support for their mental health as well. If nothing else, starting the conversation means that the person is more likely to recognise the impact of their condition on their wellbeing and seek help if they need it."
Musculoskeletal disabilities affect millions of people across the country, with rates increasing for older adults - more than a quarter of those aged 45 were affected.
The conditions account for 30% of GP consultations, and over 10 million work days a year are lost to them. Additionally, over 25% of all surgical interventions are for musculoskeletal disabilities, which account for nearly £5bn of NHS spending every year.