Associating Depression with Low Back Pain in the Population of Crete

Eirini Tsatsaraki^1, , Maria Basta², Georgios Kontakis³ and Antonis F Vakis⁴

¹Nursing Department, University of Crete, University Hospital of Heraklion, Crete, Greece

²Professor of Psychiatry, School of Medicine, University of Crete, Greece; Head of Department of Psychiatry, University Hospital of Heraklion, Crete, Greece

³Rector of the University of Crete; Professor of Orthopaedics, School of Medicine, University of Crete; Head of Department of Orthopaedics and Trauma, University Hospital of Heraklion, Crete, Greece

⁴Professor of Neurosurgery, University of Crete; Head of Department of Neurosurgery, University Hospital of Heraklion Crete, Greece

Cite this paper:
Eirini Tsatsaraki, Maria Basta, Georgios Kontakis and Antonis F Vakis. Associating Depression with Low Back Pain in the Population of Crete. American Journal of Clinical Medicine Research. 2021; 9(2):53-59. doi: 10.12691/ajcmr-9-2-4

Abstract

Low back pain is one of the most common reasons for seeking medical help in primary health care, as one of the most common conditions that cause chronic pain. There are several studies associating low back pain with depression, because of the general passive attitude of depressed people and the general psychological factors of depressed people which are involved in chronic low back pain and low back pain. Although studies have shown an association between low back pain and depression, little is known about the role of socio-demographic factors that may also play a role in this association. In particular, in Crete, with its particular socio-economic and environmental (climatic) characteristics, there is no relevant research on the relationship between back pain and depression. The aim of this study is to identify the association between low back pain and depression in patients of a large Greek region, the Region of Crete, in order to contribute to the entire Greek literature, but also to the overall effort to find solutions for patients back pain, who also have problems with depression. In order to achieve the purpose of this study, a quantitative survey was conducted. According to the results of the present study, it is concluded that the pain is more intense and affects more these patients suffering from low back pain, in contrast to the patients of the control group. In addition, severe and chronic low back pain affects both the depression and anxiety of these patients, who have more sleep problems than the control group, where there is no correlation.

Keywords:
low back pain depression anxiety sleep problems chronic pain

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References:

[1]	Wynne-Jones, G., Dunn, K. M., & Main, C. J. (2008). The impact of low back pain on work: a study in primary care consulters. European Journal of Pain, 12(2), 180-188.
[2]	Mok, L. C., & Lee, I. F. K. (2008). Anxiety, depression and pain intensity in patients with low back pain who are admitted to acute care hospitals. Journal of Clinical Nursing, 17(11), 1471-1480.
[3]	Beltsios, M., Petropoulou, K., Tega, D., Rapidi, G., Paspati, A., Magularas, N., & Lampiris, H. (1990). Epidimiological study of low back pain patients during the years 1986-87 in the area of Athens. Socioeconomic influences. Transcripts of the 16th Medical Congress in Greece, 76-82
[4]	Demyttenaere, K., Bruffaerts, R., Lee, S., Posada-Villa, J., Kovess, V., Angermeyer, M. C., ... & Von Korff, M. (2007). Mental disorders among persons with chronic back or neck pain: results from the World Mental Health Surveys. Pain, 129(3), 332-342.
[5]	Smeets, R. J., Maher, C. G., Nicholas, M. K., Refshauge, K. M., & Herbert, R. D. (2009). Do psychological characteristics predict response to exercise and advice for subacute low back pain?. Arthritis Care & Research: Official Journal of the American College of Rheumatology, 61(9), 1202-1209.
[6]	Damush, T. M., Kroenke, K., Bair, M. J., Wu, J., Tu, W., Krebs, E. E., & Poleshuck, E. (2016). Pain self-management training increases self-efficacy, self-management behaviours and pain and depression outcomes. European Journal of Pain, 20(7), 1070-1078.
[7]	Damush, T. M., Wu, J., Bair, M. J., Sutherland, J. M., & Kroenke, K. (2008). Self-management practices among primary care patients with musculoskeletal pain and depression. Journal of behavioral medicine, 31(4), 301-307.
[8]	Lee, H. J., Choi, E. J., Nahm, F. S., Yoon, I. Y., & Lee, P. B. (2018). Prevalence of unrecognized depression in patients with chronic pain without a history of psychiatric diseases. The Korean journal of pain, 31(2), 116.
[9]	Brünahl, C., Dybowski, C., Albrecht, R., Riegel, B., Höink, J., Fisch, M., & Löwe, B. (2017). Mental disorders in patients with chronic pelvic pain syndrome (CPPS). Journal of psychosomatic research, 98, 19-26.
[10]	Rayner, L., Hotopf, M., Petkova, H., Matcham, F., Simpson, A., & McCracken, L. M. (2016). Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs. Pain, 157(7), 1472.
[11]	Chen, X., Zhou, Z., Qiu, X., Wang, B., & Dai, J. (2015). The effect of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) on erectile function: a systematic review and meta-analysis. PLoS One, 10(10), e0141447.
[12]	Cocksedge, K., Shankar, R., & Simon, C. (2016). Depression and pain: the need for a new screening tool. Progress in neurology and psychiatry, 20(1), 26-32.
[13]	Beesdo, K., Pine, D. S., Lieb, R., & Wittchen, H. U. (2010). Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. Archives of general psychiatry, 67(1), 47-57.
[14]	Carroll, L. J., Cassidy, J. D., & Côté, P. (2004). Depression as a risk factor for onset of an episode of troublesome neck and low back pain. Pain, 107(1-2), 134-139.
[15]	Ohayon, M. M., & Schatzberg, A. F. (2010). Chronic pain and major depressive disorder in the general population. Journal of psychiatric research, 44(7), 454-461.
[16]	Arnow, B. A., Hunkeler, E. M., Blasey, C. M., Lee, J., Constantino, M. J., Fireman, B., ... & Hayward, C. (2006). Comorbid depression, chronic pain, and disability in primary care. Psychosomatic medicine, 68(2), 262-268.
[17]	Demyttenaere, K., Reed, C., Quail, D., Bauer, M., Dantchev, N., Montejo, A. L., ... & Grassi, L. (2010). Presence and predictors of pain in depression: results from the FINDER study. Journal of affective disorders, 125(1-3), 53-60.
[18]	Gerrits, M. M., van Oppen, P., van Marwijk, H. W., Penninx, B. W., & van der Horst, H. E. (2014). Pain and the onset of depressive and anxiety disorders. PAIN®, 155(1), 53-59.
[19]	Croft, P. R., Lewis, M., Papageorgiou, A. C., Thomas, E., Jayson, M. I., Macfarlane, G. J., & Silman, A. J. (2001). Risk factors for neck pain: a longitudinal study in the general population. Pain, 93(3), 317-325.
[20]	Shmagel, A., Foley, R., & Ibrahim, H. (2016). Epidemiology of chronic low back pain in US adults: data from the 2009–2010 National Health and Nutrition Examination Survey. Arthritis care & research, 68(11), 1688-1694.
[21]	Hoy, D., Brooks, P., Blyth, F., & Buchbinder, R. (2010). The epidemiology of low back pain. Best practice & research Clinical rheumatology, 24(6), 769-781.
[22]	Mercado, A. C., Carroll, L. J., Cassidy, J. D., & Côté, P. (2000). Coping with neck and low back pain in the general population. Health Psychology, 19(4), 333.
[23]	Pincus, T., Burton, A. K., Vogel, S., & Field, A. P. (2002). A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine, 27(5), E109-E120.
[24]	Diepenmaat, A. C. M., Van der Wal, M. F., De Vet, H. C. W., & Hirasing, R. A. (2006). Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among Dutch adolescents. Pediatrics, 117(2), 412-416.
[25]	Currie, S. R., & Wang, J. (2004). Chronic back pain and major depression in the general Canadian population. Pain, 107(1-2), 54-60.
[26]	Alsaadi, S. M., McAuley, J. H., Hush, J. M., & Maher, C. G. (2011). Prevalence of sleep disturbance in patients with low back pain. European Spine Journal, 20(5), 737-743.
[27]	Kelly, G. A., Blake, C., Power, C. K., O'keeffe, D., & Fullen, B. M. (2011). The association between chronic low back pain and sleep: a systematic review. The Clinical journal of pain, 27(2), 169-181.
[28]	Auvinen, J. P., Tammelin, T. H., Taimela, S. P., Zitting, P. J., Järvelin, M. R., Taanila, A. M., & Karppinen, J. I. (2010). Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents. European Spine Journal, 19(4), 641-649.
[29]	Ramond, A., Bouton, C., Richard, I., Roquelaure, Y., Baufreton, C., Legrand, E., & Huez, J. F. (2011). Psychosocial risk factors for chronic low back pain in primary care—a systematic review. Family practice, 28(1), 12-21.
[30]	Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., ... & Woolf, A. (2018). What low back pain is and why we need to pay attention. The Lancet, 391(10137), 2356-2367.
[31]	Fine, P. G. (2011). Long-term consequences of chronic pain: mounting evidence for pain as a neurological disease and parallels with other chronic disease states. Pain Medicine, 12(7), 996-1004.
[32]	Wáng, Y. X. J., Wáng, J. Q., & Káplár, Z. (2016). Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review. Quantitative imaging in medicine and surgery, 6(2), 199.
[33]	Williams, J. S., Ng, N., Peltzer, K., Yawson, A., Biritwum, R., Maximova, T., ... & Chatterji, S. (2015). Risk factors and disability associated with low back pain in older adults in low-and middle-income countries. Results from the WHO Study on Global AGEing and Adult Health (SAGE). PLoS One, 10(6), e0127880.
[34]	Attal, N., Perrot, S., Fermanian, J., & Bouhassira, D. (2011). The neuropathic components of chronic low back pain: a prospective multicenter study using the DN4 Questionnaire. The journal of pain, 12(10), 1080-1087.
[35]	Collados-Maestre, I., Lizaur-Utrilla, A., Martinez-Mendez, D., Marco-Gomez, L., & Lopez-Prats, F. A. (2016). Concomitant low back pain impairs outcomes after primary total knee arthroplasty in patients over 65 years: a prospective, matched cohort study. Archives of orthopaedic and trauma surgery, 136(12), 1767-1771.
[36]	Wand, B. M., Parkitny, L., O’Connell, N. E., Luomajoki, H., McAuley, J. H., Thacker, M., & Moseley, G. L. (2011). Cortical changes in chronic low back pain: current state of the art and implications for clinical practice. Manual therapy, 16(1), 15-20.
[37]	Nolet, P. S., Kristman, V. L., Côté, P., Carroll, L. J., & Cassidy, J. D. (2015). Is low back pain associated with worse health-related quality of life 6 months later?. European Spine Journal, 24(3), 458-466.
[38]	Jansen, G. B., Linder, J., Ekholm, K. S., & Ekholm, J. (2011). Differences in symptoms, functioning, and quality of life between women on long-term sick-leave with musculoskeletal pain with and without concomitant depression. Journal of Multidisciplinary Healthcare, 4, 281.
[39]	Bener, A., Verjee, M., Dafeeah, E. E., Falah, O., Al-Juhaishi, T., Schlogl, J., ... & Khan, S. (2013). Psychological factors: anxiety, depression, and somatization symptoms in low back pain patients. Journal of pain research, 6, 95.
[40]	Tekur, P., Nagarathna, R., Chametcha, S., Hankey, A., & Nagendra, H. R. (2012). A comprehensive yoga programs improves pain, anxiety and depression in chronic low back pain patients more than exercise: an RCT. Complementary therapies in medicine, 20(3), 107-118.
[41]	George, S. Z., Valencia, C., & Beneciuk, J. M. (2010). A psychometric investigation of fear-avoidance model measures in patients with chronic low back pain. journal of orthopaedic & sports physical therapy, 40(4), 197-205.
[42]	Huijnen, I. P., Verbunt, J. A., Peters, M. L., Delespaul, P., Kindermans, H. P., Roelofs, J., ... & Seelen, H. A. (2010). Do depression and pain intensity interfere with physical activity in daily life in patients with Chronic Low Back Pain?. Pain, 150(1), 161-166.
[43]	Shan, Z., Deng, G., Li, J., Li, Y., Zhang, Y., & Zhao, Q. (2013). Correlational analysis of neck/shoulder pain and low back pain with the use of digital products, physical activity and psychological status among adolescents in Shanghai. Plos one, 8(10), e78109.
[44]	Murase, K., Tabara, Y., Ito, H., Kobayashi, M., Takahashi, Y., Setoh, K., ... & Chin, K. (2015). Knee pain and low back pain additively disturb sleep in the general population: a cross-sectional analysis of the Nagahama study. PloS one, 10(10), e0140058.
[45]	Pinheiro, M. B., Ferreira, M. L., Refshauge, K., Maher, C. G., Ordoñana, J. R., Andrade, T. B., ... & Ferreira, P. H. (2016). Symptoms of depression as a prognostic factor for low back pain: a systematic review. The Spine Journal, 16(1), 105-116.
[46]	Marshall, P. W., Schabrun, S., & Knox, M. F. (2017). Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain related disability in people with chronic low back pain. PloS one, 12(7), e0180788.
[47]	Tsuji, T., Matsudaira, K., Sato, H., & Vietri, J. (2016). The impact of depression among chronic low back pain patients in Japan. BMC musculoskeletal disorders, 17(1), 1-9.