Do Patients of Chronic Low Back Pain have Psychological Comorbidities?

Abstract

Background Individuals with chronic pain have been reported to have an increased incidence of psychological morbidities. We aimed to examine the prevalence of anxiety, depression, disability, alexithymia, insomnia, and sleep quality in patients having chronic low back pain (LBP) and study their association with the severity of pain and any disability arising from it. Methods This descriptive study was conducted in a tertiary care teaching hospital setting. Fifty adults with nonspecific LBP of > 6-week duration were included. Study instruments employed were patient health questionnaire-9 for depression, generalized anxiety disorder-7 for anxiety, visual analogue scale (VAS) score for pain, Oswestry disability index (ODI) to assess disability, Toronto alexithymia scale-20 for alexithymia, and insomnia severity index and Pittsburgh sleep quality index for insomnia. Descriptive results were expressed as numbers, means, and proportions. Association study between variables was performed using Fisher’s exact test. Results Mean ODI score was 31.54% (95% CI, 26.09–36.99); mean VAS score was 6.08 (95% CI, 5.35–6.81). Insomnia of varying severity was found in 29 patients. Sleep quality was reported as good by 23 patients. One patient had alexithymia. There was significant association between the level of disability and depression, anxiety, insomnia, and sleep quality. The severity of pain had significant association with insomnia but the association with anxiety, depression, alexithymia, and sleep quality was not significant. Conclusions Patients with chronic LBP do have associated psychological comorbidities of varying extent. A “patient-centric” approach when treating patients with chronic LBP is necessary, so that appropriate evaluation of psychiatric and psychosocial comorbidities, sleep problems, and quality of life is done as part of their routine management to ensure the desired outcomes.

The role of co-occurring insomnia and mental distress in the association between lumbar disc degeneration and low back pain related disability

“…However, among individuals with co-occurring insomnia and mental distress, the association was not significant. The prevalence of insomnia has been estimated to range between ∼5% and ∼15% [44][45][46] in the general population and between ∼30% and ∼50% among individuals with LBP [47][48][49]. In our study, the prevalence of insomnia among individuals with LBP during the previous year was 36.3%, which is of a similar magnitude to previous estimates [47][48][49].…”

“…The prevalence of insomnia has been estimated to range between ∼5% and ∼15% [44][45][46] in the general population and between ∼30% and ∼50% among individuals with LBP [47][48][49]. In our study, the prevalence of insomnia among individuals with LBP during the previous year was 36.3%, which is of a similar magnitude to previous estimates [47][48][49]. The general prevalence of depression has been reported to be ∼5% [50][51][52] and the prevalence of mental distress among people with LBP ∼14% [49,53].…”

Prevalence of Lower Back Pain and its Associations with Lifestyle Behaviors among College Students in Saudi Arabia

“…Low back pain has been linked to poor sleep quality or sleep disorders in previous research [50][51][52][53].…”

Anxiety Symptoms and Associated Factors Among Chronic Low Back Pain Patients in China: A Cross-Sectional Study

“…Concerning the clinical variables, a Dutch study showed that pain intensity was significantly associated with anxiety symptoms in CLBP patients, but the association between pain duration and anxiety symptoms was not observed ( 16 ). A study conducted in India did not find a significant association between the severity of pain and anxiety ( 17 ). Families are the primary source of social support for CLBP patients, a protective determinant of mental health.…”