1
|
Chang D, Lui A, Matsoyan A, Safaee M, Aryan H, Ames C. Comparative Review of the Socioeconomic Burden of Lower Back Pain in the United States and Globally. Neurospine 2024; 21:487-501. [PMID: 38955526 PMCID: PMC11224735 DOI: 10.14245/ns.2448372.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/14/2024] [Accepted: 05/22/2024] [Indexed: 07/04/2024] Open
Abstract
Internationally, the United States (U.S.) cites the highest cost burden of low back pain (LBP). The cost continues to rise, faster than the rate of inflation and overall growth of health expenditures. We performed a comprehensive literature review of peer-reviewed and non- peer-reviewed literature from PubMed, Scopus, and Google Scholar for contemporary data on prevalence, cost, and projected future costs. Policymakers in the U.S. have long attempted to address the high-cost burden of LBP through limiting low-value services and early imaging. Despite these efforts, costs (~$40 billion; ~$2,000/patient/yr) continue to rise with increasing rates of unindicated imaging, high rates of surgery, and subsequent revision surgery without proper trial of non-pharmacologic measures and no corresponding reduction in LBP prevalence. Globally, the overall prevalence of LBP continues to rise largely secondary to a growing aging population. Cost containment methods should focus on careful and comprehensive clinical assessment of patients to better understand when more resource-intensive interventions are indicated.
Collapse
Affiliation(s)
- Diana Chang
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Austin Lui
- Department of Neurosurgery, University of California, San Francisco, University of California, San Francisco, CA, USA
| | - Alisa Matsoyan
- Department of Neurosurgery, University of California, San Francisco, University of California, San Francisco, CA, USA
| | - Michael Safaee
- Department of Neurosurgery, University of Southern California, Los Angeles, CA, USA
| | - Henry Aryan
- Department of Neurosurgery, University of California, San Francisco, University of California, San Francisco, CA, USA
| | - Christopher Ames
- Department of Neurosurgery, University of California, San Francisco, University of California, San Francisco, CA, USA
| |
Collapse
|
2
|
Weßollek K, Kowark A, Czaplik M, Rossaint R, Kowark P. Pain drawing as a screening tool for anxiety, depression and reduced health-related quality of life in back pain patients: A cohort study. PLoS One 2021; 16:e0258329. [PMID: 34634060 PMCID: PMC8504724 DOI: 10.1371/journal.pone.0258329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 09/26/2021] [Indexed: 11/30/2022] Open
Abstract
Background Back pain patients are more likely to suffer from depression, anxiety and reduced quality of life. Pain drawing is a simple, frequently used anamnesis tool that facilitates communication between physicians and patients. This study analysed pain drawings to examine whether pain drawing is suitable as a screening tool for signs of anxiety, depression or reduced quality of life, as the detection of these symptoms is essential for successful treatment. Methods Pain drawings of 219 patients with lower back pain were evaluated retrospectively. Pain drawings are a schematic drawing of a human being. Six variables of the pain drawing were analysed. Subscales of the Hospital Anxiety and Depression Scale (HADS) and the Mental Component Summary (MCS) of the Short Form 12 (SF-12) were used to measure anxiety, depression and quality of life, respectively. Descriptive statistics, uni- and multivariate linear regression analyses and analysis of variance were performed. Logistic regression analyses were conducted for suitable variables. Results We revealed significant positive correlations between the variables "filled body surface" and "number of pain sites" and the anxiety (HADS-A) and depression subscales (HADS-D) of the HADS (p<0.01). The same predictors had significant negative correlations with the MCS (p<0.01). However, the sensitivity and specificity of the variable "number of pain sites" were too low compared to those for existing screening tests to consider it as a screening tool for anxiety, depression and quality of life (HADS-A: sensitivity: 45.2%, specificity: 83.3%; HADS-D: sensitivity: 61.1%, specificity: 51%; MCS: sensitivity: 21.2%, specificity: 85.7%). Conclusions There were significant correlations between the amount of filled body surface and the number of pain sites in the pain drawing and anxiety, depression and quality of life. Although useful in routine clinical practice, pain drawing cannot be used as a screening tool based on our results.
Collapse
Affiliation(s)
- Katharina Weßollek
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
- Department of Dermatology and Allergology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
- * E-mail:
| | - Ana Kowark
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Michael Czaplik
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Rolf Rossaint
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Pascal Kowark
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| |
Collapse
|
3
|
Masaeli N, Farhadi H. Internet Addiction and Depression in Iran: Investigating the Mediating Roles of Loneliness and Disordered Sleep and Moderating Role of Gender. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2021. [DOI: 10.1007/s10447-021-09447-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
4
|
Asrar MM, Ghai B, Pushpendra D, Bansal D. Psychosocial morbidity profile in a community based sample of low back pain patients. Sci Rep 2021; 11:2610. [PMID: 33510413 PMCID: PMC7843973 DOI: 10.1038/s41598-021-82324-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/19/2021] [Indexed: 11/09/2022] Open
Abstract
Low back pain (LBP) is a major health concern and is closely associated with psychosocial morbidity and diminished Health-related quality of life (HRQoL). This is minimally investigated in community-based samples of developing nations like India. This study is aimed to specifically investigate the exposure-outcome associations between LBP and burden of disability (Modified Oswestry questionnaire (MODQ)), psychological morbidities (Depression, Anxiety and Stress Scale (DASS-21)), and HRQoL (Short Form -12 version 2 (SF12V2). A Cross-sectional study using a community-based sample of LBP positive population was conducted. The range of treatment options sought was also collected. Chi-square tests and independent t-test were used to analyze the data. Of 1531 recruited participants, 871(57%) were identified as LBP positive of whom 60% were females. Mean (SD) of age and pain intensity of LBP patients was 33 (11) years and numeric rating scale4.2 (2.6) respectively. Two-third reported minimal/moderate disability. Mean (SD) scores of depression 11.87 (4.05), anxiety (8.32), stress 13.7 (5.98), physical and mental summary scores of SF-12v2 were 47.9 (7.4) and 42.2 (10.4). A multitude of remedial options was sought for the ailment. LBP causes significant disability and psychological morbidity among affected population. This may adversely affect their HRQoL and subsequently productivity. Acupuncture was a preferred treatment sought by Indian LBP patients.
Collapse
Affiliation(s)
- Mir Mahmood Asrar
- Clinical Research Unit, Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, SAS Nagar, Mohali, Punjab, 160062, India
| | - Babita Ghai
- Department of Anesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Dhanuk Pushpendra
- Clinical Research Unit, Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, SAS Nagar, Mohali, Punjab, 160062, India
| | - Dipika Bansal
- Clinical Research Unit, Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, SAS Nagar, Mohali, Punjab, 160062, India.
| |
Collapse
|
5
|
Amiri S, Behnezhad S, Azad E. Back pain and depressive symptoms: A systematic review and meta-analysis. Int J Psychiatry Med 2020:91217420913001. [PMID: 32220220 DOI: 10.1177/0091217420913001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Low back pain is a common disorder that has many consequences. This study is an attempt to meta-analyze the risk of depression symptoms in back pain. METHOD Four databases were selected for review, and this search was conducted using key words. Eleven eligible articles were selected for review and meta-analysis was conducted. Subgroup analyses were continued with study design and the method of measuring depression. Also, the heterogeneity and publication bias were examined. RESULTS Eleven cohort and cross-sectional articles are used in the meta-analysis between back pain and depressive symptoms. The odds ratio 2.07 was calculated for this relationship. In prospective-cohort studies, 1.71 (95% confidence interval = 1.24-2.36) results indicated that back pain is a risk factor for depression symptoms and in cross-sectional studies, pooled odds ratio (2.33; 95% confidence interval = 1.29-4.21) showed that back pain is associated with depression symptoms. Some degree of publication bias was not found in the study. CONCLUSIONS Back pain is an effective factor in increasing the likelihood of depression. Adoption of effective prevention and treatment approaches can play an important role in reducing the psychological consequences in these individuals.
Collapse
Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Esfandiar Azad
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Chin-Hung Chen V, Yang YH, Chen PY, Yang JT, Chen CPC, Chen CJ, Lu ML, Lee Y, McIntyre RS, Huang YC. Factors affecting lumbar surgery outcome: A nation-wide, population-based retrospective study. J Affect Disord 2017; 222:98-102. [PMID: 28688267 DOI: 10.1016/j.jad.2017.06.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 05/05/2017] [Accepted: 06/26/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Lower back pain is a very common symptom and treatment strategies vary according the severity and duration of illness. Surgical approaches are becoming increasingly popular with the advent of new and less invasive technologies; however, treatment outcomes are not yet well established on a population-based level. Taiwan's National Health Insurance Research Database (NHIRD) is longitudinal and includes 98% of the population since its inception in 1995. The database includes the ICD 9.0 codes (International Classification of Diseases) of all patients with lower back pain and lumbar surgery; furthermore, all the prescriptions. METHODS As part of a population-based cohort study of one million participants randomly selected from the NHIRD, we analyzed changes in prescription of analgesics 1 year before and 1 year after lumbar surgery; comorbidities, such as diabetes, asthma, osteoporosis, arthritis, depression and anxiety were also analyzed as covariates. A total of 3916 cases were enrolled in final analysis. RESULTS Post-operatively, the defined daily dosage (DDD) of analgesics decreased from a median DDD of 50.0 to a median of 14.2. In a multivariate model analysis, female, older age, anxiety and asthma were the significant factors for unfavorable outcome (defined by dosage of analgesics decreased less than 50% after surgery). CONCLUSIONS The analgesics significantly decreased for patients received lumbar surgeries, implying the decreased of pain. In addition, co-morbidity factors were identified by the failure for analgesics reduction, such as female, older age, anxiety and asthma. For patients with lower back pain, these factors should be considered before receiving lumbar surgeries.
Collapse
Affiliation(s)
- Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi branch, Taiwan; Department of Medicine, Chang Gung University, Taiwan
| | - Yao-Hsu Yang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi branch, Taiwan; Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pin-Yuan Chen
- Department of Medicine, Chang Gung University, Taiwan; Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung branch, Taiwan
| | - Jen-Tsung Yang
- Department of Medicine, Chang Gung University, Taiwan; Department of Neurosurgery, Chang Gung Memorial Hospital, Chiayi branch, Taiwan
| | - Carl P C Chen
- Department of Medicine, Chang Gung University, Taiwan; Department of Rehabilitation, Chang Gung Memorial Hospital, Linkou brain, Taiwan
| | - Chi-Jen Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Mong Liang Lu
- Department of Psychiatry, Wan Fang Hospital & School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yena Lee
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry and Pharmacology, University of Toronto, Canada
| | - Yin-Cheng Huang
- Department of Medicine, Chang Gung University, Taiwan; Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung branch, Taiwan; Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou branch, Taiwan.
| |
Collapse
|
7
|
Effects of pain on activities of daily living and functioning in Parkinson’s disease patients. Transl Neurosci 2012. [DOI: 10.2478/s13380-012-0038-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Collapse
|
8
|
Change in psychosocial distress associated with pain and functional status outcomes in patients with lumbar impairments referred to physical therapy services. J Orthop Sports Phys Ther 2011; 41:969-80. [PMID: 22146493 DOI: 10.2519/jospt.2011.3814] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Prospective, longitudinal, observational cohort design. OBJECTIVE The primary aim was to examine the association between changes in psychosocial distress (PD), and functional status (FS) and pain intensity at discharge from physical therapy. BACKGROUND Patients with lumbar impairments seeking physical therapy commonly demonstrate elevated PD. However, it is not clear if PD changes that occur during physical therapy management are associated with improved clinical outcomes. METHODS Data from adults (n = 692) with lumbar impairment were analyzed. Patients were screened using the Symptom Checklist Back Pain Prediction Model questionnaire (SCL BPPM) to identify patients at intake and discharge into 3 levels of risk for persistent disability (high, intermediate, or low). SCL BPPM classifications allowed for 5 patterns of change in PD during therapy (decreased, stable low, stable intermediate, stable high, or increased). Associations between PD change patterns and discharge FS and pain intensity were assessed using multivariable linear regression models, controlling for selected risk-adjustment variables. RESULTS Proportions of patients classified by patterns of PD change for decreased, stable low, stable intermediate, stable high, and increased were 0.34, 0.52, 0.05, 0.06, and 0.03, respectively. Compared to the decreased PD group, (1) increased, stable high, and stable intermediate PD patterns were associated with worse discharge FS scores (-7.9 [95% CI: -13.5, -2.21], -10.9 [95% CI: -15.25, -6.49], and -8.9 [95% CI: -13.65, -4.21] units, respectively), and (2) stable high and stable intermediate PD patterns were associated with higher pain intensity (2.59 [95% CI: 1.81, 3.56] and 2.14 [95% CI: 1.25, 3.04] units, respectively). CONCLUSIONS Lower FS and higher pain intensity outcomes were associated in similar but not identical patterns with patients whose SCL BPPM classification of PD increased, or remained at high or intermediate levels during physical therapy. Serial assessments of change in PD during rehabilitation are recommended as a possible treatment-monitoring tool.
Collapse
|
9
|
Low back pain in Iran: a growing need to adapt and implement evidence-based practice in developing countries. Spine (Phila Pa 1976) 2011; 36:E638-46. [PMID: 21270691 DOI: 10.1097/brs.0b013e3181fa1da2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A descriptive overview of the literature. OBJECTIVE To present a comprehensive descriptive overview of the published papers about epidemiologic features, burden, and current management of low back pain (LBP) in Iran. SUMMARY OF BACKGROUND DATA Little is known about the epidemiology, burden, and management of LBP in developing and low- to middle-income countries, such as Iran. METHODS A literature search was carried out using MEDLINE database to assess existing literature about prevalence, disease burden, impact, and current management of nonspecific LBP in Iran. RESULTS Twenty-six articles matched inclusion criteria and included in the study. The findings related to point, period, and lifetime prevalence of LBP in general population, working population, school children, and pregnant women ranged from 14.4% to 84.1%. The 1-year incidence of disabling LBP was found to be 2.1%. LBP is the third leading cause of disease burden (measured by Disability Adjusted Life Years) in Iranian population aged 15 to 69 years, without considering causes of intentional and unintentional injuries. High levels of anxiety and depression among patients with LBP and the etiological role of job strain in causing LBP in workers have been reported in Iran. Our search failed to find any articles about referral system, direct and indirect costs, social determinants, and current management of LBP in Iran. CONCLUSION This overview of the literature illustrates that LBP is a common symptom and an important cause of disease burden in Iran, in particular, in the most productive age for both males and females. The 1-year incidence of disabling LBP in Iran was found to be low. Future research will be necessary to investigate economic cost, social determinants, health technology assessment, and management of LBP in Iran.
Collapse
|
10
|
Tuzer V, Bulut SD, Bastug B, Kayalar G, Göka E, Beştepe E. Causal attributions and alexithymia in female patients with fibromyalgia or chronic low back pain. Nord J Psychiatry 2011; 65:138-44. [PMID: 20874000 DOI: 10.3109/08039488.2010.522596] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS Our general objective was to assess the psychological symptoms and the types of causal attributions linked to the symptoms among women chronic pain. METHODS 70 fibromyalgia (FM) patients, 56 chronic low back pain (CLBP) patients and 72 healthy controls were assessed within a general hospital setting, using the Toronto Alexithymia Scale, Brief Symptom Inventory and Symptom Interpretation Questionnaire. Three-way analysis of variance and chi-square tests were used for inter-group comparisons, followed by multivariate correlation, covariate analysis and linear regression. RESULTS Alexithymia, somatization, depression, anxiety and hostility scores were significantly higher in FM patients relative to CLBP patients and healthy controls (P < 0.05). Alexithymia was linked to psychological attributions in FM patients and to somatic attributions in CLBP patients. Psychological attributions, the number of symptoms and difficulty in describing emotions were related to increased anxiety in FM patients. Depression, anxiety and somatization were significantly increased in subjects with high alexithymia scores in the FM group. There was no difference between groups regarding causal attributions. CONCLUSIONS Causal attributions do not seem to have distinctive features between functional somatic syndromes like FM and CLBP, though differences might exist between groups as to the effects of coexisting psychological distress symptoms like anxiety and depression.
Collapse
Affiliation(s)
- Verda Tuzer
- Numune Training and Research Hospital, First Psychiatry Clinic, Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
11
|
Association between centralization, depression, somatization, and disability among patients with nonspecific low back pain. J Orthop Sports Phys Ther 2010; 40:801-10. [PMID: 20972348 DOI: 10.2519/jospt.2010.3334] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Secondary analysis of a prospective observational cohort study. OBJECTIVES To evaluate whether depression and somatization subscores of the Symptom Checklist-90-Revised (SCL-90-R), which have been shown to identify chronic disability in individuals with nonspecific low back pain, are applicable to a different population of individuals with low back pain; and to determine if this potential association is confounded by a combination of centralization and subsequent treatment based on centralization. BACKGROUND To help direct management of patients with nonspecific low back pain, recommendations include performing tests designed to identify psychosocial risk factors predictive of poor patient outcomes. SCL-90-R depression and somatization subscores have been shown to predict chronic disability among patients with low back pain. METHODS SCL-90-R depression and somatization subscores and data on centralization were collected during the initial physical therapy examination of 231 consecutive patients treated for low back pain in 2 clinics. Disability was assessed by the Oswestry Disability Questionnaire at intake and discharge from physical therapy, and work status was determined by patient self-report at 6 and 12 months after discharge. Pain intensity was assessed by the numeric pain rating scale at the initial visit, and at 6- and 12-month follow-ups. Data were analyzed using logistic regression. RESULTS Odds ratios for the association between depression and somatization subscores and patient outcomes ranged from 0.76 to 2.93. For analyses in which the data suggested a trend toward an association, the association was less evident following adjustment for centralization and centralization-based treatment. CONCLUSIONS In our sample, in which all individuals received physical therapy, and those who centralized received interventions based on the direction of centralization, SCL-90-R depression and somatization subscores were moderately associated with chronic pain and disability. This association was reduced when centralization and centralization-based treatment was considered in multivariable analyses.
Collapse
|
12
|
El-Sayed AM, Hadley C, Tessema F, Tegegn A, Cowan JA, Galea S. Back and neck pain and psychopathology in rural sub-Saharan Africa: evidence from the Gilgel Gibe Growth and Development Study, Ethiopia. Spine (Phila Pa 1976) 2010; 35:684-9. [PMID: 20139812 PMCID: PMC2891327 DOI: 10.1097/brs.0b013e3181b4926e] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Community-based cross-sectional analysis of the relation between symptoms of psychopathology and back pain (BP) or neck pain (NP) in rural southwest Ethiopia. OBJECTIVE Using data from a community-based sample, we assessed the prevalence and psychopathologic correlates of BP or NP in rural sub-Saharan Africa. SUMMARY OF BACKGROUND DATA BP and NP are among the most prevalent pain conditions. Psychopathology has been shown to be associated with both BP and NP in developed and urban developing contexts. Little is known about the relation between psychopathology and BP or NP in the rural, developing context. METHODS Data on self-reported BP and NP, symptoms of depression, anxiety, and post-traumatic stress (PTS), gender, age, and socioeconomic status were collected from a representative cohort sample (N = 900) in rural southwest Ethiopia. We calculated univariate statistics to assess the prevalence of BP and NP. We used bivariate χ2 tests and multivariate logistic regression models to assess the relation between psychopathology and BP and NP. RESULTS The prevalence of BP was 16.7%; that of NP was 5.0%. In χ2 analyses, symptoms of depression, anxiety, and PTS were significantly associated with increased risk for each outcome. In models adjusted for age, household assets, and gender, depression symptomatology was associated with increased risk for BP (OR = 3.44, 95% CI: 2.37-5.00) and NP (OR = 4.92, 95% CI: 2.49-9.74). Anxiety symptomatology was also associated with increased risk for BP (OR = 2.88, 95% CI: 1.98-4.20) and NP (OR = 2.67, 95% CI: 1.41-5.09). PTS symptomatology was associated with increased risk for BP (OR = 2.89, 95% CI: 1.78-4.69). CONCLUSION In the first known study about the relation between psychopathologic symptomatology and BP and NP in a rural context in a developing country, the prevalence of BP and NP were comparable to published data in developed and developing countries. Symptoms of depression and anxiety were correlates of BP and NP, and symptoms of PTS were a correlate of BP. Comparative studies about the relation between psychopathology and chronic pain conditions between rural and urban contexts in the global south are needed.
Collapse
Affiliation(s)
- Abdulrahman M El-Sayed
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI, University of Michigan Medical School, Ann Arbor, MI
| | - Craig Hadley
- Department of Anthropology, Emory University, Atlanta, GA
| | | | | | - John A Cowan
- Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI
| | - Sandro Galea
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, Center for Global Health, University of Michigan, Ann Arbor, MI
| |
Collapse
|
13
|
Goldstein HB, Safaeian P, Garrod K, Finamore PS, Kellogg-Spadt S, Whitmore KE. Depression, abuse and its relationship to interstitial cystitis. Int Urogynecol J 2008; 19:1683-6. [PMID: 18766291 DOI: 10.1007/s00192-008-0712-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Accepted: 08/12/2008] [Indexed: 11/24/2022]
Abstract
This study evaluated the prevalence of depression, sexual abuse, and physical abuse among women diagnosed with interstitial cystitis (IC). One hundred forty-one subjects completed the validated Beck's Depression Inventory II Questionnaire (BDI-II) and the validated Drossman Abuse Questionnaire. Ninety-seven (69%) subjects scored 14 or higher on the BDI-II, corresponding to depression. When compared to the US prevalence of 9%, this was significantly higher. Fifty-one subjects (36%) reported sexual abuse which is higher than the US average. The prevalence of childhood sexual abuse in the sample was not significantly different than the US average. The prevalence of physical abuse in the sample was not statistically different than the US average. Women with IC appear to have a higher prevalence of depression and sexual abuse than the general population. Women with IC should be screened for depression and abuse and referred to a mental health expert as necessary for treatment.
Collapse
Affiliation(s)
- H B Goldstein
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Cooper University Hospital, Voorhees, NJ, USA.
| | | | | | | | | | | |
Collapse
|
14
|
Abstract
BACKGROUND Studies concerning comorbidity in patients with chronic low back pain and its correlation to the stage of chronification are rare. METHODS This case-control study (matched-pair analysis) examines the number and specificity of comorbidity as well as the extent of disability due to comorbidity in 51 patients with chronic low back pain compared to age- and sex-matched control persons. Moreover, the correlation of comorbidity and the stage of chronification was analysed in these patients. RESULTS Patients with chronic low back pain had significantly more comorbidities and a higher disability due to comorbidity compared to the control persons. The higher the stage of chronification according to the Mainz Pain Staging System (MPSS) the higher was the number of comorbidities. CONCLUSION Comorbidity should be given due consideration when evaluating diagnosis, therapy, prognosis and therapy outcome in patients with chronic low back pain.
Collapse
Affiliation(s)
- M Buchner
- Orthopädische Universitätsklinik Heidelberg, Kleingemünder Strasse 72/5, 69118, Heidelberg.
| | | | | | | |
Collapse
|