Although various epidemiologic studies have found that chronic back pain is comorbid with psychiatric disorders, little is known about the temporal relationship between the two. In this study, the relationship between chronic back pain and psychiatric disorders was disentangled both cross-sectionally and longitudinally. Data are from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a prospective survey conducted among adults in the Netherlands. Anxiety, mood and substance use disorders were diagnosed with the Composite International Diagnostic Interview (CIDI). Self-report was used to ascertain chronic back pain. The key findings are that persons with chronic back pain are more likely to have anxiety, mood and substance use disorders. These results add to the growing body of knowledge that chronic back pain is associated not only with depression but also with anxiety and substance use disorder. Secondly, this study provides support for both the consequence (chronic back pain precedes the development of anxiety disorders) and the antecedent hypothesis (anxiety disorders precede the development of chronic back pain). Regarding the consequence hypothesis, it was found that pre-existing chronic back pain not only elevates the risk of developing a mood disorder, but also of anxiety disorders. Regarding the antecedent hypothesis, it was found that anxiety disorders predict new onset chronic back pain. It is concluded that care providers should be aware of the co-occurrence of chronic back pain and psychiatric disorders. Screening tools for psychiatric disorders and guidelines should be made available for the treatment of both chronic back pain and psychiatric disorders.