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Evaluation of the relationship between disability and pain severity with anxiety and depression in chronic low back pain patient: Research and review

Narges Beyraghi, Maryam Hosseinzadeh, Masood Hashemi, Yashar Nasiri Moghaddam


Background: Chronic disabling physical and mental symptoms contribute to substantial health-care costs and reduced human productivity. Low back pain (LBP) and depression are leading causes of years lived with disability in every country. Almost half of chronic LBP individuals have comorbid depression and anxiety conditions with a higher risk in female gender. This is a very common comorbidity, and the psychological comorbidities have a negative impact on chronicity of LBP symptoms. Psychological distress and depressed mood have been reported to be correlated with chronicity and persisting disability of chronic LBP. The aim of this study is to investigate the correlation of pain and disability and associated factors in a subgroup of depressed and anxious individual with chronic LBP (CLBP). Materials and Methods: A total of 74 CLBP participants in a university pain clinic with depression or anxiety diagnosis were enrolled. Hospital anxiety depression scale (HADS) for depression and anxiety, visual analog scale for pain severity, and Oswestry disability index were recorded for disability evaluation. Correlation and regression analysis was used to evaluate the effect of different factors on disability and depression. Results: Around 49 women and 25 men participated in this study. Duration of CLBP was 12.97 ± 9.27, and scores of depression and anxiety were 14.24 ± 3.41 and 12.95 ± 2.74, respectively. Disability and pain severity was 32.62 ± 9.9 and 5.67 ± 1.34, respectively. There was a significant relationship between disability and other scores. Pain and depression had a signifi cant correlation with disability, and the eff ect of depression (β = 0.357) on disability was more than pain (β = 0.331). Conclusion: Due to our results, there is a signifi cant relationship between psychiatric (depression and anxiety) and clinical factors (disability and pain) in patients with CLBP. The score of disability was higher than pain intensity and depression was the most important predictor factor of disability which must be recognized and treated in CLBP patients. Our results support that depression can predict disability and to some extend pain severity in CLBP patients.


Chronic low back pain; depression; disability; pain

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