Depression Impacts the Course of Recovery in Patients with Acute Low-Back Pain

Little is known about the course of recovery of acute low back pain (LBP) patients as a function of depression. In a prospective study, 286 acute LBP patients were assessed at baseline and followed up over 6 months. Recovery was defined as improvement in the Oswestry Disability Index (ODI). Repeated-measures analysis of covariance was employed with ODI as repeated factor, age, sex, and body mass index as covariates, depression and all other potential prognostic factors as between-subject factors. Of study participants, 18% were classified as depressive (>33 points on the Zung Self-Rating Depression Scale). Of 286 participants, 135 were lost to follow-up. In the longitudinal sample of 151 patients the course of recovery was slower in depressive patients. Depression was associated with LBP especially after 6 weeks and should therefore be included in screening instruments for acute LBP patients to identify those at risk of delayed recovery at an early stage.

[1]  A. Elfering,et al.  Prognostic occupational factors for persistent low back pain in primary care , 2013, International Archives of Occupational and Environmental Health.

[2]  Brendan Burkett,et al.  The Örebro Musculoskeletal Screening Questionnaire: validation of a modified primary care musculoskeletal screening tool in an acute work injured population. , 2012, Manual therapy.

[3]  A. Elfering,et al.  Predictors of sickness absence in patients with a new episode of low back pain in primary care. , 2012, Industrial health.

[4]  J. Meixensberger,et al.  Affective, anxiety, and substance-related disorders in patients undergoing herniated disc surgery , 2011, Social Psychiatry and Psychiatric Epidemiology.

[5]  Kristin R. Archer,et al.  The Effect of Fear of Movement Beliefs on Pain and Disability After Surgery for Lumbar and Cervical Degenerative Conditions , 2011, Spine.

[6]  Jorma Styf,et al.  The Impact of Fear-Avoidance Model Variables on Disability in Patients With Specific or Nonspecific Chronic Low Back Pain , 2011, Spine.

[7]  A. Rydall,et al.  Patterns of depression in cancer patients: an indirect test of gender-specific vulnerabilities to depression , 2011, Social Psychiatry and Psychiatric Epidemiology.

[8]  C. Maher,et al.  A modified Delphi approach to standardize low back pain recurrence terminology , 2011, European Spine Journal.

[9]  A. Elfering,et al.  Predicting the transition from acute to persistent low back pain. , 2011, Occupational medicine.

[10]  M. Melloh,et al.  Predictive ability of a modified Örebro Musculoskeletal Pain Questionnaire in an acute/subacute low back pain working population , 2011, European Spine Journal.

[11]  C. Schmidt,et al.  Does attrition bias longitudinal population‐based studies on back pain? , 2011, European journal of pain.

[12]  S. George,et al.  A psychometric investigation of fear-avoidance model measures in patients with chronic low back pain. , 2010, The Journal of orthopaedic and sports physical therapy.

[13]  C. Maher,et al.  How little pain and disability do patients with low back pain have to experience to feel that they have recovered? , 2010, European Spine Journal.

[14]  Antoni Serrano-Blanco,et al.  Prevalence of mental disorders in primary care: results from the diagnosis and treatment of mental disorders in primary care study (DASMAP) , 2010, Social Psychiatry and Psychiatric Epidemiology.

[15]  P. Hampel,et al.  Effects of gender and cognitive-behavioral management of depressive symptoms on rehabilitation outcome among inpatient orthopedic patients with chronic low back pain: a 1 year longitudinal study , 2009, European Spine Journal.

[16]  A. Elfering,et al.  Identification of prognostic factors for chronicity in patients with low back pain: a review of screening instruments , 2009, International Orthopaedics.

[17]  M. Hancock,et al.  Can rate of recovery be predicted in patients with acute low back pain? Development of a clinical prediction rule , 2009, European Journal of Pain.

[18]  A. Elfering,et al.  Development of a screening tool predicting the transition from acute to chronic low back pain for patients in a GP setting: Protocol of a multinational prospective cohort study , 2008, BMC musculoskeletal disorders.

[19]  Thomas Zweig,et al.  Bmc Musculoskeletal Disorders Differences across Health Care Systems in Outcome and Cost-utility of Surgical and Conservative Treatment of Chronic Low Back Pain: a Study Protocol , 2022 .

[20]  Yanni G. Malliaris,et al.  Rumination-focused cognitive behaviour therapy for residual depression: a case series. , 2007, Behaviour research and therapy.

[21]  L. Bachmann,et al.  Value of predictive instruments to determine persisting restriction of function in patients with subacute non-specific low back pain. Systematic review , 2007, European Spine Journal.

[22]  H. Baumeister,et al.  Prevalence of mental disorders based on general population surveys , 2007, Social Psychiatry and Psychiatric Epidemiology.

[23]  A. Mannion,et al.  Clinical update: low back pain , 2007, The Lancet.

[24]  M. Sullivan,et al.  Initial Depression Severity and the Trajectory of Recovery Following Cognitive-Behavioral Intervention for Work Disability , 2006, Journal of Occupational Rehabilitation.

[25]  T. Mayer,et al.  Prevalence of Psychiatric Disorders in Patients With Chronic Disabling Occupational Spinal Disorders , 2006, Spine.

[26]  K. Jordan,et al.  Characterizing the course of low back pain: a latent class analysis. , 2006, American journal of epidemiology.

[27]  J. Katz,et al.  Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. , 2006, The Journal of bone and joint surgery. American volume.

[28]  H. Ursin,et al.  Chapter 4 European guidelines for the management of chronic nonspecific low back pain , 2006, European Spine Journal.

[29]  B. Koes,et al.  Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care , 2006, European Spine Journal.

[30]  Jianli Wang,et al.  More data on major depression as an antecedent risk factor for first onset of chronic back pain , 2005, Psychological Medicine.

[31]  N. Vøllestad,et al.  Clinical Course and Prognostic Factors in Acute Low Back Pain: Patients Consulting Primary Care for the First Time , 2005, Spine.

[32]  K. Refshauge,et al.  Screening for symptoms of depression by physical therapists managing low back pain. , 2004, Physical therapy.

[33]  M. Härter,et al.  Recognition of psychiatric disorders in musculoskeletal and cardiovascular rehabilitation patients. , 2004, Archives of physical medicine and rehabilitation.

[34]  W. Eaton,et al.  Depressive disorder as a long-term antecedent risk factor for incident back pain: a 13-year follow-up study from the Baltimore Epidemiological Catchment Area Sample , 2004, Psychological Medicine.

[35]  J. David Cassidy,et al.  Depression as a risk factor for onset of an episode of troublesome neck and low back pain , 2004, Pain.

[36]  S. Linton,et al.  Early Identification of Patients at Risk of Developing a Persistent Back Problem: The Predictive Validity of The Örebro Musculoskeletal Pain Questionnaire , 2003, The Clinical journal of pain.

[37]  M. Härter,et al.  A descriptive study of psychiatric disorders and psychosocial burden in rehabilitation patients with musculoskeletal diseases. , 2002, Archives of physical medicine and rehabilitation.

[38]  M. Roland,et al.  The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. , 2000, Spine.

[39]  S. Nolen-Hoeksema,et al.  The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. , 2000, Journal of abnormal psychology.

[40]  C. L. Mandle,et al.  Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients , 1999, Pain.

[41]  S. Linton,et al.  Can we screen for problematic back pain? A screening questionnaire for predicting outcome in acute and subacute back pain. , 1998, The Clinical journal of pain.

[42]  A. Silman,et al.  Psychologic Distress and Low Back Pain: Evidence From a Prospective Study in the General Population , 1995, Spine.

[43]  T. Mayer,et al.  Psychiatric Illness and Chronic Low-Back Pain: The Mind and the Spine—Which Goes First? , 1993, Spine.

[44]  S. Hollis,et al.  The Distress and Risk Assessment Method: A Simple Patient Classification to Identify Distress and Evaluate the Risk of Poor Outcome , 1992, Spine.

[45]  J. Coyne,et al.  Psychosocial predictors of depression. Prospective evidence from the human population laboratory studies. , 1987, American journal of epidemiology.

[46]  J C Fairbank,et al.  The Oswestry low back pain disability questionnaire. , 1980, Physiotherapy.

[47]  R. Melzack.  The McGill Pain Questionnaire: Major properties and scoring methods , 1975, PAIN.

[48]  C. Maher,et al.  How is recovery from low back pain measured? A systematic review of the literature , 2010, European Spine Journal.

[49]  W. Rief,et al.  Depression in chronic back pain patients: prediction of pain intensity and pain disability in cognitive-behavioral treatment. , 2010, Psychosomatics.

[50]  M. Höfler,et al.  Pain associated with specific anxiety and depressive disorders in a nationally representative population sample , 2009, Social Psychiatry and Psychiatric Epidemiology.

[51]  A. Breen,et al.  A review and proposal for a core set of factors for prospective cohorts in low back pain: a consensus statement. , 2008, Arthritis and rheumatism.

[52]  Scott R. Bishop,et al.  The Pain Catastrophizing Scale: Development and validation. , 1995 .

[53]  R. Gatchel,et al.  Predicting outcome of chronic back pain using clinical predictors of psychopathology: a prospective analysis. , 1995, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.