Evaluation of the Psychological Status in Chronic Low Back Pain: Comparison with General Population (original) (raw)
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Psychological Profile of Patients with Chronic Low Back Pain
Journal of Gandhara Medical and Dental Science, 2021
OBJECTIVES: To assess the frequency of depression, anxiety, and stress in patients with Chronic Low Back Pain (CLBP) using Depression Anxiety Stress Scale (DASS-42). METHODOLOGY: This descriptive study was performed from January 2019 to June 2019. All those patients with chronic low back pain with duration of more than 6 months were included. Patients below 20 and above 60 years were excluded to eliminate the effect of extreme ages. The Depression Anxiety Stress Scale (DASS-42) was used in this study. RESULTS: In this study, a total of 127 patients were successfully interviewed. The mean age of the sample was 36.46 (SD±7.38) with a minimum age of 22 years and maximum of 59 years. Out of these 127 patients, 83 (65.4%) were female while 44 (34.6%) were male patients. The minimum duration of chronic low back pain in our patients was 8 months while the maximum was 55 months with a mean of 28 months (SD 9.9). The mean DASS score for depression was 11.8 (SD±4.23), anxiety was 7.5 (SD±2.9)...
CHRONIC LOW BACK PAIN& PSYCHOLOGICAL COMORBIDITY
International Journal of Development Research, 2019
Aim:Low back pain is a common disease, and it is observed at least once in 70-85% of the population during their lifetime.Chronic low back pain (CLBP)interferes with the physical ability and mobility of high number of people. This study will determine if there is a relationship between mental disorders including depression, hypochondriasis and anxiety, and the functional status of patients suffering from chronic low back pain.Subjects and methods: The study was performed on a sample of 200 agreed to participate in this cross-sectional study. The patients were divided equally into two separate groups: first group consisted patients with chronic low back pain with clear organic lesion and validated radiologically.The second group consisted of patients with chronic low back pain in which no clinical and radiological confirmation for an organic lesion, or called functional group. Every patient has undergone to the following procedures: A) Medical evaluation including (Neurological evaluation, systemic examination mainly gynecological examination in all female patients and radiological examination mainly Plain x-ray of lumbosacral spine and Magnetic Resonence Imaging(MRI) lumbosacral spine. B) The psychological evaluation used to measure anxiety, depression and hypochondriasis by adopting the MMPI Questionnaire Results: This study sample has included 53% males and 47% females in organic group while 30% males and 70% females in functional group. In Organic group, age and LBPwere found to be significantly associated. Radiation was absent in 9% of patients in organic group and in 60% of patients in functional group. Parathesia present in 85% of organic group, while functional group 20%. 70% of those in organic group and 25% of those in functional group reported severe pain.Depressionwas observed in 15% oforganic group participants and in 35% of patients of functional group in LBP patients. Depression scores reported in the functional group are strikingly higher than that inthe group with organic lesion.Anxiety were (14%) in organic group, 20% in functional group, hysteria scores in the second group are decidedly higher than that in the group with organic lesions. Hypochondriasis disorders reported in 9.5%of organic pain patients and in 15% of functional pain group.Hypochondriasis scorewas found to be definitely higher in the functional groupthan in the organic group.Conclusion: Depression, anxiety, and hypochondriasis are highly prevalent among people with chronic low back pain. So in order to manage the pain, it is useful to treat patient’s mental dysfunctions that will probably improve their functional status. This way, patients can avoid addictive management and treatment regimens prescribed by their physician to treat their functional disabilities.
Psychological factors: anxiety, depression, and somatization symptoms in low back pain patients
Journal of Pain Research, 2013
To determine the prevalence of low back pain (LBP), investigate the sociodemographic characteristics of patients with LBP, and examine its association with psychological distress such as anxiety, depression, and somatization. Subjects and methods: Of the 2742 patients approached, 2180 agreed to participate in this cross-sectional study (79.5% response rate). The survey was conducted among primary health care visitors from March to October 2012 and collected sociodemographic details and LBP characteristics. General Health Questionnaire-12 was used to identify the probable cases. Anxiety was assessed with Generalized Anxiety Disorder-7, depression was assessed with Patient Health Questionnaire-9, and somatization was measured with Patient Health Questionnaire-15. Results: The study sample consisted of 52.9% males and 47.1% females. The prevalence of LBP was 59.2%, comprising 46.1% men and 53.9% women. LBP was significantly higher in Qataris (57.9%), women (53.9%), housewives (40.1%), and individuals with higher monthly income (53.9%). Somatization (14.9%) was observed more in LBP patients, followed by depression (13.7%) and anxiety disorders (9.5%). The most frequently reported symptoms were "headaches" (41.1%) and "pain in your arms, legs, or joints" (38.5%) in LBP patients with somatization. The most frequent symptoms among depressed LBP patients were "thinking of suicide or wanting to hurt yourself " (51.4%) and "feeling down, depressed, or hopeless" (49.2%). "Not being able to stop or control worrying" (40.2%), "worrying too much about different things" (40.2%), and "feeling afraid as if something awful might happen" (40.2%) were the most common anxiety symptoms in LBP patients. Psychological distress such as anxiety (9.5% versus 6.2%), depression (13.7% versus 8.5%), and somatization (14.9% versus 8.3%) were significantly higher in LBP patients. Conclusion: The prevalence of LBP in this study sample was comparable with other studies. Furthermore, psychological distress such as anxiety, depression, and somatization were more prevalent in LBP patients compared to patients without LBP.
Psychological Aspects of Chronic Low Back Pain: A Review
Objective: To review the relationships between chronic low back pain (CLBP) and psychopathology in the light of relevant literature and to help clinicians more easily assess and treat this common disabling condition. Method: Recent literature was investigated using the online Web databases Medline/PUBMED, Proquest and Science Direct from 1990 to the present (2007). Of over 250 articles searched, 124 selected on their relevance to the chronic low back pain states. Results: The relationship between chronic pain and psychopathology has generated substantial empirical and theoretical interest, with depressive disorders receiving much of the attention. Although no single theoretical model can fully explain the causal relationship between CLBP and psychopathology, diathesis-stress model and fear avoidance model are emerging as the dominant overarching theoretical perspectives. Conclusion: Evaluation of psychopathology may help foreseeing the functional outcome of the patient and unwanted treatment outcomes because unrecognized and untreated psychopathology can significantly interfere with both successful surgical treatment and subsequent rehabilitation of the patients suffering with CLBP. It seems that cognitive-behavior therapy (CBT) should be an essential part of the multidisciplinary treatment for patients with chronic low back pain.
Patterns of psychological disturbance and pain report in patients with low back pain
Journal of Psychosomatic Research, 1982
Low back pain is described as more severe and more diffuse by patients who are psychologically disturbed than by patients who are not psychologically disturbed. In order to further elucidate the association between descriptions of pain and psychological disturbance, the relationship between pain and Minnesota Multiphasic Personality Inventory (MMPI) profiles was studied. Three groups of patients, defined by MMPI profiles, were given a standard pain questionnaire. The first group, without clinically significant elevations on any MMPI scale, described the least pain. The second group, defined by a 'conversion V' MMPI profile, described increased sensory attributes of pain and increased general intensity. The third group, defined by clinically significant elevations on both the neurotic and psychotic MMPI triads, described sensory attributes and general intensity similar to the second group, but more severe anguish and suffering. These results suggest that magnification of mood-related attributes of pain may be associated with more openly admitted psychological disturbance.
Pain, 1981
The principal dimensions of the pain experience of 102 patients with chronic low back pain were studied and components of the pain experience were compared to pretreatment measures of emotional disturbance. Responses on the McGill Pain Questionnaire (MPQ) were factor analyzed revealing dimensions of the pain experience that seemed to represent sensory, affective, and evaluative aspects. Patients with high scores on the MMPI hypochondriasis scale portrayed their pain as more intense and as high in terms of affective and evaluative descriptors on the MPQ. Other MMPI scales reflecting emotional disturbance (depression, hysteria) were also associated with a more intense description of pain and higher scores on an affective descriptor dimension. The evaluative descriptive dimension was highly related to the overall intensity of the pain experience. Only the affective dimension was related to emotional disturbance separately from the effects of intensity alone.
Understanding Psychological factors In Relation To Chronic Low Back Pain- A Review Study
Low back pain is one of the major and common musculoskeletal problems effecting a large population throughout the world and its transition from acute to chronic phase is associated with various psychological factors. Low Back Pain is pain, muscle tension or stiffness localized below costal margins and above the inferior gluteal folds with or without sciatica and is defined as chronic when it persists for 12 weeks or more .Psychological factors play an important role in people with chronic low back pain as experience of pain is shaped by host of psychological factors. Experimental studies have proposed that psychological and social factors can influence biological factors, such as hormone production activity in autonomic nervous system and physical deconditioning .Psychological basis of low back pain can be explained on the basis of factors such as Attention, Expectation, Beliefs, Emotion and Anxiety, pain behavior and Learning and memory. Chronic Low back pain is a physical and emotional suffering, but is poorly understood and addressed from the psychological standpoint. Chronic low back pain results in decreased psychological health of the individual leading to depression, anxiety, stress etc which in deed further worsen the pain and deteriorate the psychological well being.
The detection of psychological disturbance in patients with low back pain
Journal of Psychosomatic Research, 1979
The feasibility of developing a pain scale for detecting psychological disturbance in patients with low back pain was investigated in two studies. In the first study, stepwise discriminant analysis was used to identify the best combination of pain terms that would discriminate the functional group from the organic group. Thirteen pain variables were identified which correctly identified 93.6 % of the cases of low back pain. These pain terms were used to categorize 159 new cases in the second. Cross-validation shrinkage was only 10.6%. One hundred and thirty-two out of 159 cases in the new sample were correctly classified. The advantages of this pain scale over existing methods are discussed, along with implications for clinical orthopedic practice.
Emotional and disability status in patients with chronic low back pain
International Journal of Radiology & Radiation Therapy, 2020
Objective: to analyze the prevalence of psychological disorders (anxiety, depression, stress) and the relationship of these factors with functional disability in patients with chronic low back pain. Study design: cross-sectional descriptive and observational study. Setting: the physiotherapy outpatient clinic of the Northen University of Paraná, Londrina, Paraná, Brazil. Methods: 84 individuals were recruited, being 43 elderly (20 with low back pain and 23 control subjects) and 41 adults (21 with low back pain and 20 control subjects). In order to assess the psychological aspects, Beck Inventories of Depression and anxiety as well as Lipp Stress Inventory were used. To evaluate the funcionality, Roland Morris Questionnaire was chosen. The evaluation of the pressure pain threshold was performed using algometer emg systems®. To analyse was considered a significance level of 5% (p<0.05). Results: It was observed that people with low back pain have higher scores of depression, anxiet...
Comparison of three measures for detecting psychological disturbance in patients with low back pain
PAIN, 1982
The MMPI Low Back Scale, the 'Conversion V' MMPI profile and the Back Pain Classification Scale were compared for accuracy in detecting psychological disturbance in a sample of 91 patients with low back pain. These patients were classified as to the presence or absence of organic findings and psychological disturbance on the basis of objective and independent evaluations. Hit rates of 37.4%, 64.5~ and 78.0~ were produced by the 3 measures, respectively. The Back Pain Classification Scale was the most accurate measure, and the only scale to exceed base rate. The implications of these findings for clinical practice are discussed.