1
|
Xu Y, Wang Y, Chen J, He Y, Zeng Q, Huang Y, Xu X, Lu J, Wang Z, Sun X, Chen J, Yan F, Li T, Guo W, Xu G, Tian H, Xu X, Ma Y, Wang L, Zhang M, Yan Y, Wang B, Xiao S, Zhou L, Li L, Zhang Y, Chen H, Zhang T, Yan J, Ding H, Yu Y, Kou C, Jia F, Liu J, Chen Z, Zhang N, Du X, Du X, Wu Y, Li G. The comorbidity of mental and physical disorders with self-reported chronic back or neck pain: Results from the China Mental Health Survey. J Affect Disord 2020; 260:334-341. [PMID: 31521871 DOI: 10.1016/j.jad.2019.08.089] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/24/2019] [Accepted: 08/28/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND To investigate mental and physical health comorbidity with chronic back or neck pain in the Chinese population, and assess the level of disability associated with chronic back or neck pain. METHODS Data were derived from a large-scale and nationally representative community survey of adult respondents on mental health disorders in China (n = 28,140). Chronic back or neck pain, other chronic pain conditions and chronic physical conditions were assessed by self-report. Mental disorders were assessed by the Composite International Diagnostic Interview (CIDI). Role disability during the past 30 days was assessed with the World Health Organization Disability Assessment Schedule (WHO-DAS-II). RESULTS The 12-month prevalence of chronic back or neck pain was 10.8%. Most of respondents with chronic back or neck pain (71.2%) reported at least one other comorbid condition, including other chronic pain conditions (53.4%), chronic physical conditions (37.9%), and mental disorders (23.9%). It was found by logistic regression that mood disorders (OR = 3.7, 95%CI:2.8-4.8) showed stronger association with chronic back or neck pain than anxiety disorders and substance disorders. Most common chronic pains and physical conditions were significantly associated with chronic back or neck pain. Chronic back or neck pain was associated with role disability after controlling for demographics and for comorbidities. Physical and mental comorbidities explained 0.7% of the association between chronic back or neck pain and role disability. CONCLUSIONS Chronic back or neck pain and physical-mental comorbidity is very common in China and chronic back or neck pain may increase the likelihood of other physical and mental diseases. This presents a great challenge for both clinical treatment and public health education. We believe that further study needs to be conducted to improve the diagnostic and management skills for comorbidity conditions.
Collapse
Affiliation(s)
- Yifeng Xu
- Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Yan Wang
- Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Jianhua Chen
- Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Yanling He
- Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Qingzhi Zeng
- Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Yueqin Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhizhong Wang
- Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Xian Sun
- Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Jing Chen
- Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Feng Yan
- Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Tao Li
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Wanjun Guo
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | | | | | - Xiangdong Xu
- The Fourth People's Hospital in Urumqi, Urumqi, China
| | - Yanjuan Ma
- The Fourth People's Hospital in Urumqi, Urumqi, China
| | - Limin Wang
- National Center for Chronic and NonCommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mei Zhang
- National Center for Chronic and NonCommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yongping Yan
- Department of Epidemiology, Air Force Medical University of the Chinese People's Liberation Army, Xi'an, China
| | - Bo Wang
- Department of Epidemiology, Air Force Medical University of the Chinese People's Liberation Army, Xi'an, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China
| | - Liang Zhou
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital, Central-south University, Changsha, China
| | - Yan Zhang
- Mental Health Institute, the Second Xiangya Hospital, Central-south University, Changsha, China
| | - Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Tingting Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Jie Yan
- Department of Biostatistics, School of Public Health, School of Government, and Institute of Social Science Survey, Peking University, Beijing, China
| | - Hua Ding
- Department of Biostatistics, School of Public Health, School of Government, and Institute of Social Science Survey, Peking University, Beijing, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangzhou, China
| | - Jian Liu
- The Seventh Hospital of Hangzhou, Hangzhou, China
| | - Zheli Chen
- Huzhou Third People's Hospital, Huzhou, China
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Xinbai Du
- The Third People's Hospital of Qinghai Province, Xining, China
| | - Xiangdong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yue Wu
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Guohua Li
- Chifeng Anding Hospital, Chifeng, China
| |
Collapse
|
2
|
Dapunt U, Gantz S, Zhuk A, Gather K, Wang H, Schiltenwolf M. Quantitative sensory testing in physically active individuals and patients who underwent multidisciplinary pain therapy in the longitudinal course. J Pain Res 2018; 11:2323-2330. [PMID: 30410387 PMCID: PMC6200080 DOI: 10.2147/jpr.s173000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of this study was to evaluate possible differences of quantitative sensory testing (QST) results in healthy individuals (group control, n=20), physically active individuals (group sport, n=30) and in patients suffering from chronic musculoskeletal pain (group pain, n=30). Methods Thermal detection thresholds, thermal pain thresholds and blunt pressure pain thresholds were measured at various sites (T0). Additionally, group pain was treated in multidisciplinary pain therapy for 4 weeks. All groups were retested after 4 weeks to evaluate the reliability of QST measurements and to investigate possible early changes following treatment (T1). Results Importantly, QST-measurements showed stable test results for group sport and group control at both time points. Athletes demonstrated the highest pain thresholds in general (cold pain threshold mean in degree Celsius for the hand: 5.76, lower back right: 7.25, lower back left: 7.53; heat pain threshold mean in degree Celsius for the hand: 46.08, lower back right: 45.77, lower back left: 45.70; and blunt pressure pain mean in kilograms for the hand: 3.54, lower back right: 5.26, lower back left: 5.46). Patients who underwent therapy demonstrated significant differences at T1 (cold pain threshold hand mean in degree Celsius for the hand: 11.12 [T0], 15.12 [T1]; and blunt pressure pain mean in kilograms for the lower back right: 2.87 [T0], 3.56 [T1]). They were capable of enduring higher blunt pressure, but on the other hand cold pain tolerance had decreased (P=0.045 and P=0.019, respectively). Conclusions In conclusion, we were able to demonstrate significant differences of QST results among the three groups and we detected early changes following multidisciplinary pain therapy, which will be discussed.
Collapse
Affiliation(s)
- Ulrike Dapunt
- Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse, Heidelberg, Germany,
| | - Simone Gantz
- Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse, Heidelberg, Germany,
| | - Anastasiya Zhuk
- Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse, Heidelberg, Germany,
| | - Katharina Gather
- Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse, Heidelberg, Germany,
| | - Haili Wang
- Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse, Heidelberg, Germany,
| | - Marcus Schiltenwolf
- Center for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse, Heidelberg, Germany,
| |
Collapse
|
3
|
Quality of life assessment in musculo-skeletal health. Aging Clin Exp Res 2018; 30:413-418. [PMID: 28664458 DOI: 10.1007/s40520-017-0794-8] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 06/23/2017] [Indexed: 12/18/2022]
Abstract
Musculoskeletal disorders affect morbidity, quality of life and mortality, and represent an increasing economic and societal burden in the context of population aging and increased life expectancy. Improvement of quality of life should be one of the priorities of any interventions to prevent and treat musculoskeletal disorders in the ageing population. Two main approaches, namely generic and disease-specific instruments, can be applied to measure health-related quality of life. Among the generic tools available in scientific literature, the short form 36 questionnaire (SF-36) and the Euroqol five item questionnaire (EQ-5D) are two of the most popular questionnaires used to quantify the health related quality of life in people with musculoskeletal disorders. However, because generic tools may not always be able to detect subtle effects of a specific condition on quality of life, a specific tool is highly valuable. Specific tools improve the ability to clinically characterize quality of life in subjects with a specific musculoskeletal disorder, as well as the capacity to assess changes over time in the QoL of these subjects. The recent development of specific tools should help to validate preventive and therapeutic interventions in this field.
Collapse
|
4
|
Van Damme B, Stevens V, Van Tiggelen D, Perneel C, Crombez G, Danneels L. Performance based on sEMG activity is related to psychosocial components: differences between back and abdominal endurance tests. J Electromyogr Kinesiol 2014; 24:636-44. [PMID: 24956968 DOI: 10.1016/j.jelekin.2014.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 05/08/2014] [Accepted: 05/29/2014] [Indexed: 10/25/2022] Open
Abstract
The influence of psychosocial components on back and abdominal endurance tests in patients with persistent non-specific low back pain should be investigated to ensure the correct interpretation of these measures. Three-hundred and thirty-two patients (291 men and 41 women) from 19 to 63years performed an abdominal and back muscle endurance test after completing some psychosocial questionnaires. During the endurance tests, surface electromyography signals of the internal obliques, the external obliques, the lumbar multifidus and the iliocostalis were recorded. Patients were dichotomized as underperformers and good performers, by comparing their real endurance time, to the expected time of endurance derived from the normalized median frequency slope. Independent t-tests were performed to examine the differences on the outcome of the questionnaires. In the back muscle endurance test, the underperformers had significantly lower (p<0.05) scores on some of the physical subscales of the SF-36. The underperformers group of the AE test scored significantly higher on the DRAM MZDI (p=0.018) and on the PCS scale (p=0.020) and showed also significantly lower scores on the SF-36 (p<0.05). Back muscle endurance tests are influenced by physical components, while abdominal endurance tests seem influenced by psychosocial components.
Collapse
Affiliation(s)
- Benedicte Van Damme
- Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Veerle Stevens
- Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Damien Van Tiggelen
- Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
5
|
Vereckei E, Edit V, Susanszky E, Eva S, Kopp M, Maria K, Ratko I, Istvan R, Czimbalmos A, Agnes C, Nagy Z, Zsolt N, Palkonyai E, Eva P, Hodinka L, Laszlo H, Temesvari PI, Peter TI, Kiss E, Emese K, Töro K, Klara T, Poor G, Gyula P. Psychosocial, educational, and somatic factors in chronic nonspecific low back pain. Rheumatol Int 2012; 33:587-92. [PMID: 22476243 DOI: 10.1007/s00296-012-2398-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 03/11/2012] [Indexed: 12/17/2022]
Abstract
Analysis of the effect of psychosocial factors and co-morbidities on the health status of patients with chronic nonspecific low back pain and patients with surgical intervention because of disk herniation was performed. One hundred and two nonselected consecutive inpatients with chronic nonspecific low back pain were included in the study. Their average age was 56.7 (SD = 10.9) years. The control group consisted of 199 subjects matched according to age and sex, chosen from the database of the national representative health survey Hungarostudy 2006, which involved 4,527 subjects. We measured quality of life including mental health with the SF-36 questionnaire validated for use in Hungary, the short 9-item version of the Beck Depression Inventory, the WHO-Five Well-Being Index, and the Hospital Anxiety-Depression Scale. We characterized the socio-demographic status with variables on age, sex, marital status, and education. Data on symptoms and signs of low back pain, other musculoskeletal diseases, and their treatments including spinal surgery were recorded. Co-morbidity and body mass index were considered as independent indicators of health. Depression as measured by Beck Depression Inventory and severity of depression did not vary significantly according to marital status, education, hypertension, diabetes, and gastrointestinal disease. Only half of the patients (52 %) were in the normal range of the scale; 22 % suffered from mild, 16 % from moderate, and 12 % from severe depression. Average values for anxiety and depression as measured by Hospital Anxiety-Depression Scale and Beck Depression Inventory were both significantly higher in the patient than in the control group (Hospital Anxiety Scale: p = 0.0001; Beck Depression Inventory: p = 0.0001). According to the WHO Well-Being Index-5 scale, the difference between patients and the control group was significant (p = 0.0001). Furthermore, correlation was found between the incidence of depression and surgery. Depression was demonstrated in 47.4 % of those patients who had no surgery, in 50 % of patients who had one round of surgery, and in 62.5 % of those who had undergone surgery more than once; the contingence coefficient was 0.211. According to different measurements, the psychological state of patients with chronic nonspecific low back pain was significantly altered as compared to the matched Hungarian population. Higher anxiety and depression markers occurred in 48 % of the patients. There was no correlation between the depression of patients with low back pain and variables such as marital status, education, and co-morbidities. Our study is the first to demonstrate that depression runs parallel with the number of surgical procedures. Therefore, if there is a relative indication for surgery, depression and severity of depression should be assessed and considered when deciding on the intervention.
Collapse
Affiliation(s)
- Edit Vereckei
- National Institute of Rheumatology and Physiotherapy, Budapest, Hungary.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Luedtke K, Rushton A, Wright C, Juergens TP, Mueller G, May A. Effectiveness of anodal transcranial direct current stimulation in patients with chronic low back pain: design, method and protocol for a randomised controlled trial. BMC Musculoskelet Disord 2011; 12:290. [PMID: 22204615 PMCID: PMC3339335 DOI: 10.1186/1471-2474-12-290] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 12/28/2011] [Indexed: 11/24/2022] Open
Abstract
Background Electrical stimulation of central nervous system areas with surgically implanted stimulators has been shown to result in pain relief. To avoid the risks and side effects of surgery, transcranial direct current stimulation is an option to electrically stimulate the motor cortex through the skull. Previous research has shown that transcranial direct current stimulation relieves pain in patients with fibromyalgia, chronic neuropathic pain and chronic pelvic pain. Evidence indicates that the method is pain free, safe and inexpensive. Methods/Design A randomised controlled trial has been designed to evaluate the effect of transcranial direct current stimulation over the motor cortex for pain reduction in patients with chronic low back pain. It will also investigate whether transcranial direct current stimulation as a prior treatment enhances the symptom reduction achieved by a cognitive-behavioural group intervention. Participants will be randomised to receive a series of 5 days of transcranial direct current stimulation (2 mA, 20 mins) or 20 mins of sham stimulation; followed by a cognitive-behavioural group programme. The primary outcome parameters will measure pain (Visual Analog Scale) and disability (Oswestry Disability Index). Secondary outcome parameters will include the Fear Avoidance Beliefs Questionnaire, the Funktionsfragebogen Hannover (perceived function), Hospital Anxiety Depression Scale, bothersomeness and Health Related Quality of Life (SF 36), as well as Patient-Perceived Satisfactory Improvement. Assessments will take place immediately prior to the first application of transcranial direct current stimulation or sham, after 5 consecutive days of stimulation, immediately after the cognitive-behavioural group programme and at 4 weeks, 12 weeks and 24 weeks follow-up. Discussion This trial will help to determine, whether transcranial direct current stimulation is an effective treatment for patients with chronic low back pain and whether it can further enhance the effects of a cognitive behavioural pain management programme. Trial registration: Current Controlled Trials ISRCTN89874874.
Collapse
Affiliation(s)
- Kerstin Luedtke
- Institute of Systems Neurosciences, University Hospital Eppendorf, Martinistr,52, 20246 Hamburg, Germany.
| | | | | | | | | | | |
Collapse
|
7
|
Jansen GB, Linder J, Ekholm KS, Ekholm J. Differences in symptoms, functioning, and quality of life between women on long-term sick-leave with musculoskeletal pain with and without concomitant depression. J Multidiscip Healthc 2011; 4:281-92. [PMID: 21847350 PMCID: PMC3155858 DOI: 10.2147/jmdh.s21827] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Indexed: 12/21/2022] Open
Abstract
Objective: The aim was to describe the differences in symptoms, functioning and quality of life between women on long-term sick-leave due to protracted musculoskeletal pain with and without concomitant depression. Design: Descriptive and comparisons with/without comorbid depression. Methods: 332 female patients were examined by three specialist physicians in psychiatry, orthopedic surgery, and rehabilitation medicine and assigned to four groups according to the ICD-10 diagnoses: low back/joint disorders (LBJ, n = 150), myalgia (M, n = 43), fibromyalgia (FM, n = 87), or depression without somatic pain diagnosis (DE, n = 52). Results: Patients with somatic pain conditions LBJ, M, or FM showed more activity-related difficulties if concomitant depression was present during the activities ‘focusing attention’, ‘making decisions’, and ‘undertaking a single task’; and in the domains ‘energy level’, ‘memory functions’, ‘emotional functions’, and ‘optimism/pessimism’. Patients with FM and concomitant depression perceived higher pain intensity than patients in group DE. No statistically significant differences in physically related activities were noted between each of the somatic pain conditions with and without coexisting depression. FM patients with coexisting depression reported fewer painful sites on their pain drawings compared with FM-patients without depression. Patients with LBJ or FM and concomitant depression reported lower quality of life in the dimensions vitality, social functioning, emotional role, and mental health. Comorbid depression affected disability and restricted working capacity by reducing mental activity and functioning but not by affecting physical activity problems. Conclusion: Women on long-term sick-leave, who have concomitant depression with LBJ or FM, also have more difficulties in focusing attention, making decisions, and carrying out tasks, and with memory functions and optimism/pessimism, as well as reduced quality of life in the dimensions of vitality, social functioning, emotional role, and mental health, than female patients without comorbid depression. As a consequence we suggest further efforts to integrate somatic and psychiatric interventions in the same rehabilitation program.
Collapse
|
8
|
Current world literature. Curr Opin Support Palliat Care 2011; 5:174-83. [PMID: 21521986 DOI: 10.1097/spc.0b013e3283473351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|