A Systematic Review of Psychological Factors as Predictors of Chronicity/Disability in Prospective Cohorts of Low Back Pain

Pincus, Tamar; Burton, A. Kim; Vogel, Steven; Field, Andy P.

doi:10.1097/00007632-200203010-00017

Cited by 1,422 publications

(941 citation statements)

References 49 publications

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“…Age is a potential confounder in the relationship between depression and LBP and should be accounted for. In fact, when studies that investigated older participants only (6,13,14) were pooled, a stronger association was found (OR 1.98, 95% CI 1.40-2.81, I 2 5 51%) compared to the overall pooling of primary analysis (OR 1.59, 95% CI 1.26-2.01, I 2 5 59%). It is likely that depression might have a stronger effect in increasing the risk of LBP in older people, but the factors that explain this relationship are still unclear.…”

Section: Discussionmentioning

confidence: 96%

“…Some studies have found depression to be associated with an increased risk of developing LBP (6)(7)(8), while other studies have failed to show a significant association (9)(10)(11). Previous reviews investigating the role of psychological variables in LBP have shown evidence of depression as a predictor of poor outcomes, such as chronicity, disability, and work absenteeism (12)(13)(14). However, these reviews did not specifically focus on premorbid depression as a risk factor for new cases of LBP.…”

Section: Introductionmentioning

confidence: 99%

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Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

Pinheiro

Ferreira

Refshauge

et al. 2015

Arthritis Care & Research

151

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Objective. To investigate the contribution of symptoms of depression to future episodes of low back pain (LBP). Methods. A search was conducted of AMED, CINAHL, Embase, Health and Society (H&S), LILACS, MEDLINE, PsycINFO, Scopus, and Web of Science databases. We included cohort studies investigating the effect of symptoms of depression on the development of new episodes of LBP, either lifetime incidence or a recurrent episode, in a population free of LBP at baseline. We accepted the original study's definition for a new episode of LBP, and for classifying patients as LBP-free at study entry. Two independent investigators extracted data and assessed methodological quality. Meta-analyses with random effects were used to pool risk estimates. Results. We included 19 studies, with 11 incorporated in the meta-analyses. Overall pooled results showed that symptoms of depression increased the risk of developing LBP (odds ratio [OR] 1.59, 95% confidence interval [95% CI] 1.26-2.01). The risk was similar in studies that used the diagnostic interview method (OR 1.66, 95% CI 1.14-2.42) and in studies using selfreport screening questionnaires (OR 1.68, 95% CI 1.05-2.70). No statistically significant relationship was observed when we pooled studies that employed nonspecific screening questionnaires (OR 1.17, 95% CI 0.48-2.87). Three studies provided results in incremental categories of symptoms of depression and the pooled OR for the most severe level of depression (OR 2.51, 95% CI 1.58-3.99) was higher than for the lowest level (OR 1.51, 95% CI 0.89-2.56). Conclusion. Individuals with symptoms of depression have an increased risk of developing an episode of LBP in the future, with the risk being higher in patients with more severe levels of depression.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

Pinheiro

Ferreira

Refshauge

et al. 2015

Arthritis Care & Research

151

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4][5][6][7][8][9] FAB refer to the fear-induced avoidance of movements or activities which are expected to be painful, whereas catastrophizing is defined as an exaggerated negative mental state related to an actual or anticipated painful experience. [1][2][3][4][5][6][7][8][9] In the Spanish cultural environment, FAB have shown to have an either negligible or nonexistent influence on LBP among elderly populations and among acute, subacute and chronic LBP patients treated in routine practice, [10][11][12][13] whereas catastrophizing correlates with disability and explains approximately one fourth of its variance, 13,14 suggesting that it may have an influence on the prognosis of LBP patients.…”

Section: Introductionmentioning

confidence: 99%

The prognostic value of catastrophizing for predicting the clinical evolution of low back pain patients: a study in routine clinical practice within the Spanish National Health Service

et al. 2012

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“…Exhaustive research has failed to find a correlation between pain, structural damage in the spine and the level of disability in non-specific LBP [2,3]. Among the factors that predict disability and chronicity from LBP, patients' beliefs about fear-avoidance, pain-impairment relationship and coping strategies are strongly associated with outcome from treatment [4,5]. Accordingly, a biopsychosocial model has been proposed to explain the process through which LBP causes disability and tends to become chronic.…”

Section: Introductionmentioning

confidence: 99%

Psychometric properties and factor structure of the Spanish version of the HC-PAIRS questionnaire

et al. 2012

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Objective To develop a Spanish version of the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and to test its psychometric properties. Methods A forward and backward translation methodology was used to translate the questionnaire, which was then applied to 206 participants (174 physiotherapy students and 32 family physicians). The intraclass correlation coefficient was calculated to assess test-retest reliability. Internal consistency was evaluated using Cronbach's alpha and item analysis. Construct validity was measured using Pearson correlation coefficients between HC-PAIRS and FABQ, FABQ-Phys, FABQ-Work and the responses given by participants to three clinical case scenarios. An exploratory factor analysis was carried out following the Kaiser normalization criteria and principal axis factoring with an oblique rotation (quartimax). Sensitivity to change was assessed after a teaching module.Results Test-retest reliability was ICC 0.50 (p \ 0.01) and Cronbach's alpha was 0.825. The HC-PAIRS scores correlated significantly with the scores of the FABQ and also with the recommendations for work and activity given by the participants in the three clinical case scenarios. Sensitivity to change test showed an effect size of 1.5, which is considered a large change. Factor analysis suggests that the Spanish version of HC-PAIRS measures a unidimensional construct. Conclusion The Spanish version of the HC-PAIRS has proven to be a reliable, valid and sensitive instrument to assess health care providers' attitudes and beliefs about LBP. It can be used in evaluating clinical practice and in undergraduate acquisition of skills and knowledge.

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A Systematic Review of Psychological Factors as Predictors of Chronicity/Disability in Prospective Cohorts of Low Back Pain

Cited by 1,422 publications

References 49 publications

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta‐Analysis

The prognostic value of catastrophizing for predicting the clinical evolution of low back pain patients: a study in routine clinical practice within the Spanish National Health Service

Psychometric properties and factor structure of the Spanish version of the HC-PAIRS questionnaire

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