Depressive Symptoms Are Associated With Decreased Quality of Life and Work Ability in Currently Working Health Care Workers With Recurrent Low Back Pain

The mediating role of depressive symptoms among Turkish population related to gender and low back pain: evidence from a national health survey

BACKGROUND

Low back pain (LBP), though non-life-threatening, burdens healthcare with treatment expenses and work hours lost. Globally, 70-84% experience it, with risk factors tied to societal structure, income, and living conditions, making it a leading cause of disability.

METHODS

This study utilized data from the 2019 Türkiye Health Survey, which consisted of 17,084 individuals aged 15 and above. Our study focused on investigating the factors related to low back pain through a cross-sectional analysis. To analyze these factors, we employed binary multivariate logistic regression. Additionally, we conducted post-hoc analyses to assess the potential mediating effect of depressive symptoms on the relationship between low back pain and gender.

RESULTS

We found that 31.9% of the population experienced low back pain, with women being 58% more likely [aOR = 1.58; 95% CI (1.45-1.73)] than men to report symptoms. Individuals aged 55 + years old had a 90% [aOR = 1.90; 95% CI (1.61-2.23)] chance of experiencing low back pain, indicating an age-related increase. In the general population, having depressive symptoms was 2.49 [95% CI (2.23-2.78)] times more likely associated with low back pain. Our mediation analysis showed that gender (i.e., women vs. men), indicated by direct effects with β-estimates e = 0.78, predicted the likelihood of low back pain. Additionally, the relationship between gender and low back pain, mediated through a history of depressive symptoms, had a significant total indirect effect (i.e., β-estimate given as e = 0.49). Specifically, a history of depressive symptoms accounted for 17.86% [95% CI (9.67-20.10)] of the association between women having a higher likelihood of low back pain compared to men.

CONCLUSION

We observed that a higher likelihood of low back pain associated with gender and aging. Additionally, BMI served as a significant predictor, particularly in adults. Depression mediated the association between gender and low back pain. Acknowledging these associations may help identify and address contributing factors to LBP, potentially increasing awareness and alleviating the burden. Policymakers and healthcare professionals may consider these findings when developing prevention and treatment programs for low back pain.

Prevalence and correlates of depression among students in a senior high school in Ghana: A school-based cross-sectional study

Objectives

Depression is one of the most widely reported mental health issues that affect adolescents globally. However, there is a dearth of data on its prevalence and associated factors among senior high school students in Ghana, since previous studies have focused more on adult populations. This can hinder policies needed to champion mental health and mental health care in senior high schools. Hence, this study sought to assess the prevalence of depression and associated factors among senior high school students in Ghana.

Methods

An analytical cross-sectional study involving 289 students at the Manya Krobo Senior High School was conducted from December 2022 to February 2023. The students were selected using a two-stage random sampling method. A questionnaire was used to collect data on sociodemographics and individual characteristics. The primary outcome was depression, and this was assessed using the Patient Health Questionnaire-9. Summary statistics were presented as means, frequencies, and percentages. Multivariate logistic regression was used to identify factors associated with depression and odds ratios presented with 95% confidence intervals. Statistical significance was considered at p-value < 0.05.

Results

The mean age of the students was 16.6 (±1.2) with a range of 14-20 years. Over a quarter (26.3%) of the students reported financial difficulties. The prevalence of depression among the students was 68.9%. The factors associated with depression in this study were female sex (adjusted odds ratio: 1.74, 95% confidence interval: 1.01-2.97), age (adjusted odds ratio: 1.41, 95% confidence interval: 1.10-1.81), history of chronic health condition (adjusted odds ratio: 3.74, 95% confidence interval: 1.36-10.25), and financial difficulties (adjusted odds ratio: 2.31, 95% confidence interval: 1.15-4.63).

Conclusion

This study shows that depression is rife among students at the Manya Krobo Senior High School, Manya Krobo District, Ghana. These findings call for pragmatic interventions such as strengthening counseling units and professional mental health services to ameliorate the impact of depression on the lives of students.

Accelerometer-Measured Physical Behavior and Cardiorespiratory Fitness as Indicators of Work Ability

Work ability (WA) reflects an individual's resources, work demands, and related environment. Self-reports have shown that higher physical activity (PA) is associated with better WA. This study investigated associations of accelerometer-measured (24/7) physical behavior and cardiorespiratory fitness (CRF) with WA. In the FinFit2017-population-based study, the physical behavior of 20-69-year-old working Finns was measured in terms of PA, standing, and sedentariness using validated MAD-APE algorithms based on raw triaxial accelerometer data. During waking hours, the accelerometer was hip-worn, while during the time in bed (TIB), it was worn on the non-dominant wrist. CRF was measured with a 6 min walk test. WA was assessed by four questions excerpted from the Work Ability Index (WAI), called the short WAI (sWAI). Participants (n = 1668, mean age 46.6, SD = 10.9, 57% women) scored on average 23.3 on the sWAI (range 6-27), with a higher value indicating a better WA. More minutes in standing (p = 0.001) and in moderate (p = 0.004) and vigorous PA (p < 0.001) as well as a higher step number (p < 0.001) and better CRF (p < 0.001) were associated with a higher sWAI value. More time spent lying down (p < 0.001) and in high-movement (p < 0.001) and total TIB (p = 0.001) was associated with a lower sWAI. Detailed analysis of 24/7 physical behavior can be utilized in identifying individual-related indicators of WA.