Mental health indicators and quality of life among individuals with musculoskeletal chronic pain: a nationwide study in Iceland

Björnsdóttir, Sigrún Vala; Jönsson, Sofia; Valdimarsdóttir, Unnur

doi:10.3109/03009742.2014.881549

Cited by 37 publications

(25 citation statements)

References 13 publications

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“…Such relationships have been found both in chronic pain cohorts and in population-based studies [75][76][77]. These cross-sectional correlations were confirmed in our study and extended also to the longitudinal aspects (Table 5), as we found significant correlations between pain intensities in all anatomical regions as well as for PainNosreg and PainVASreg at baseline and GSI at follow-up ( Table 6).…”

Section: Discussionsupporting

confidence: 88%

The relationships between pain, disability, and health-related quality of life: an 8-year follow-up study of female home care personnel

Lundberg

Gerdle

2015

Disability and Rehabilitation

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Spreading of pain and the average intensity of pain across the involved anatomical regions have importance for future pain and disability and quality of life. The clinical assessment of subjects with chronic pain prior to rehabilitation interventions has to determine the spreading of pain rather than just focusing on the area with the most intense pain. The different developments over time for pain intensity and disability indicate the need for applying a bio-psycho-social view of pain both when assessing the patient with pain and when discussing the prognosis and course of the actual pain condition with the patient.

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Section: Discussionsupporting

confidence: 88%

The relationships between pain, disability, and health-related quality of life: an 8-year follow-up study of female home care personnel

Lundberg

Gerdle

2015

Disability and Rehabilitation

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“…7,13,22,39,41,51 Such relationships have been found both in chronic pain cohorts and in population-based studies. 4,32,43 In addition, systematic reviews have confirmed evidence for a link between pain and low HRQoL. 32,37 In a systematic review, Leadly et al 32 noted a lack of studies concerning the elderly population.…”

Section: Discussionmentioning

confidence: 92%

Severity of chronic pain in an elderly population in Sweden—impact on costs and quality of life

Bernfort

Gerdle

Rahmqvist

et al. 2015

Pain

101

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Chronic pain is associated with large societal costs, but few studies have investigated the total costs of chronic pain with respect to elderly subjects. The elderly usually require informal care, care performed by municipalities, and care for chronic diseases, all factors that can result in extensive financial burdens on elderly patients, their families, and the social services provided by the state. This study aims to quantify the societal cost of chronic pain in people of age 65 years and older and to assess the impact of chronic pain on quality of life. This study collected data from 3 registers concerning health care, drugs, and municipal services and from 2 surveys. A postal questionnaire was used to collect data from a stratified sample of the population 65 years and older in southeastern Sweden. The questionnaire addressed pain intensity and quality of life variables (EQ-5D). A second postal questionnaire was used to collect data from relatives of the elderly patients suffering from chronic pain. A total of 66.5% valid responses of the 10,000 subjects was achieved; 76.9% were categorized as having no or mild chronic pain, 18.9% as having moderate chronic pain, and 4.2% as having severe chronic pain. Consumed resources increased with the severity of chronic pain. Clear differences in EQ-5D were found with respect to the severity of pain. This study found an association between resource use and severity of chronic pain in elderly subjects: the more severe the chronic pain, the more extensive (and expensive) the use of resources.

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“…Past research is consistent with this outcome, indicating that patients undergoing various kinds of back surgery report improvements in levels of anxiety and depression 1 year following the procedure. 17,25 These findings, in correlation with the association of poor mental health and musculoskeletal pain, 7 all provide strong evidence that cervical deformity is q an underlying cause in the depression of its patients. To further understand this model of depression, future research is needed.…”

Section: Figmentioning

confidence: 83%

Despite worse baseline status depressed patients achieved outcomes similar to those in nondepressed patients after surgery for cervical deformity

Poorman

Passias

Horn

et al. 2017

Neurosurgical Focus

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OBJECTIVEDepression and anxiety have been demonstrated to have negative impacts on outcomes after spine surgery. In patients with cervical deformity (CD), the psychological and physiological burdens of the disease may overlap without clear boundaries. While surgery has a proven record of bringing about significant pain relief and decreased disability, the impact of depression and anxiety on recovery from cervical deformity corrective surgery has not been previously reported on in the literature. The purpose of the present study was to determine the effect of depression and anxiety on patients’ recovery from and improvement after CD surgery.METHODSThe authors conducted a retrospective review of a prospective, multicenter CD database. Patients with a history of clinical depression, in addition to those with current self-reported anxiety or depression, were defined as depressed (D group). The D group was compared with nondepressed patients (ND group) with a similar baseline deformity determined by propensity score matching of the cervical sagittal vertical axis (cSVA). Baseline demographic, comorbidity, clinical, and radiographic data were compared among patients using t-tests. Improvement of symptoms was recorded at 3 months, 6 months, and 1 year postoperatively. All health-related quality of life (HRQOL) scores collected at these follow-up time points were compared using t-tests.RESULTSSixty-six patients were matched for baseline radiographic parameters: 33 with a history of depression and/or current depression, and 33 without. Depressed patients had similar age, sex, race, and radiographic alignment: cSVA, T-1 slope minus C2–7 lordosis, SVA, and T-1 pelvic angle (p > 0.05). Compared with nondepressed individuals, depressed patients had a higher incidence of osteoporosis (21.2% vs 3.2%, p = 0.028), rheumatoid arthritis (18.2% vs 3.2%, p = 0.012), and connective tissue disorders (18.2% vs 3.2%, p = 0.012). At baseline, the D group had greater neck pain (7.9 of 10 vs 6.6 on a Numeric Rating Scale [NRS], p = 0.015), lower mean EQ-5D scores (68.9 vs 74.7, p < 0.001), but similar Neck Disability Index (NDI) scores (57.5 vs 49.9, p = 0.063) and myelopathy scores (13.4 vs 13.9, p = 0.546). Surgeries performed in either group were similar in terms of number of levels fused, osteotomies performed, and correction achieved (baseline to 3-month measurements) (p < 0.05). At 3 months, EQ-5D scores remained lower in the D group (74.0 vs 78.2, p = 0.044), and NDI scores were similar (48.5 vs 39.0, p = 0.053). However, neck pain improved in the D group (NRS score of 5.0 vs 4.3, p = 0.331), and modified Japanese Orthopaedic Association (mJOA) scores remained similar (14.2 vs 15.0, p = 0.211). At 6 months and 1 year, all HRQOL scores were similar between the 2 cohorts. One-year measurements were as follows: NDI 39.7 vs 40.7 (p = 0.878), NRS neck pain score of 4.1 vs 5.0 (p = 0.326), EQ-5D score of 77.1 vs 78.2 (p = 0.646), and mJOA score of 14.0 vs 14.2 (p = 0.835). Anxiety/depression levels reported on the EQ-5D scale were significantly higher in the depressed cohort at baseline, 3 months, and 6 months (all p < 0.05), but were similar between groups at 1 year postoperatively (1.72 vs 1.53, p = 0.416).CONCLUSIONSClinical depression was observed in many of the study patients with CD. After matching for baseline deformity, depression symptomology resulted in worse baseline EQ-5D and pain scores. Despite these baseline differences, both cohorts achieved similar results in all HRQOL assessments 6 months and 1 year postoperatively, demonstrating no clinical impact of depression on recovery up until 1 year after CD surgery. Thus, a history of depression does not appear to have an impact on recovery from CD surgery.

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Mental health indicators and quality of life among individuals with musculoskeletal chronic pain: a nationwide study in Iceland

Abstract: Our data indicate that individuals with musculoskeletal chronic pain have increased risk of poor mental health and diminished QoL. Further studies are needed on treatment and preventative measures of a decline in mental health among individuals with chronic pain.

Cited by 37 publications

References 13 publications

The relationships between pain, disability, and health-related quality of life: an 8-year follow-up study of female home care personnel

The relationships between pain, disability, and health-related quality of life: an 8-year follow-up study of female home care personnel

Severity of chronic pain in an elderly population in Sweden—impact on costs and quality of life

Despite worse baseline status depressed patients achieved outcomes similar to those in nondepressed patients after surgery for cervical deformity

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