The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review

Abstract

Background: A considerable proportion of adults with low back pain (LBP) suffer from depressive symptoms or depression. Those with depressive symptoms or depression may be at risk of poorer LBP recovery and require more health care. Understanding the role of prognostic factors for LBP is critically important to guide management and health services delivery. Our objective is to conduct a systematic review to assess the association between depressive symptoms or depression and health outcomes in adults with LBP with or without radiculopathy. Methods: Electronic databases including MEDLINE, Embase, CINAHL, and PsycINFO will be searched from inception to April 2019 to identify relevant studies. Additional citations will be identified by searching reference lists of included studies and related systematic reviews. Cohort and case-control studies assessing the association between depressive symptoms/ depression and health outcomes in adults aged 16 years and older with LBP with or without radiculopathy will be included. The following will be included: depressive symptoms as measured on standardized questionnaires (e.g., Center for Epidemiologic Studies Depression Scale, Beck Depression Index), and depression as standardized diagnoses (e.g., International Classification of Diseases codes) or self-reported depression diagnosis on standardized questionnaires. Outcomes of interest are standardized measures for pain, disability, overall health status, satisfaction with care, and health care utilization. These are informed by core outcome domains that international expert panels consider important for LBP research. Pairs of reviewers will screen articles retrieved from the search, extract data, and assess risk of bias using the Risk Of Bias In Non-randomized Studies-of Exposures (ROBINS-E) tool. Reviewers will use these criteria to inform their judgment on the internal validity of studies (e.g., low, moderate, or high risk of bias). If studies are deemed homogeneous, a random effects meta-analysis on the association between depressive symptoms and health outcomes will be performed. The results of the included studies will be descriptively outlined if studies are deemed heterogeneous. Discussion: The impact of depressive symptoms and depression on health-and health care-related outcomes for LBP with or without radiculopathy will be assessed and quantified. Findings of this systematic review will advance our understanding of LBP prognosis, and guide decision-making and improve quality of care for adults with LBP. Systematic review registration: PROSPERO CRD42019130047

Use of the PROMIS-10 global health in patients with chronic low back pain in outpatient physical therapy: a retrospective cohort study

“…The association between depression and cLBP is well-documented and it warrants attention in outpatient physical therapy practice [ 36 , 48 – 51 ]. Although a meta-analysis by Wong et al found depression 20% of the population with cLBP [ 10 ], we observed depression in 37% of our analytic sample. In the MH-LOW group, nearly 60% of patients had been diagnosed with depression.…”

“…In particular, health-related quality of life (HRQoL)—defined as patient’s self-perceived function and well-being in physical, mental, and social domains of health [ 7 , 8 ]—is often negatively impacted by cLBP [ 8 ]. Previous studies have demonstrated that patients with cLBP are often limited in physical activities [ 9 ], have poor mental health status indicated by anxiety and depression [ 10 ], and participation restrictions in social activities [ 11 ]. HRQoL is one of the core outcome domains recommended for measurement in cLBP population [ 12 ]; yet the extent of HRQoL measurement in physical therapy practice has been mixed [ 13 ].…”

The effects of lower back pain due to herniated disc on sleep, quality of life and depression symptoms

“…There was a significant increase in depression in the examination of gender-independent BDI scores of patients with low back pain [14]. Moreover, treatments for depressive symptoms and depression in individuals with chronic pain help improve low back pain [15]. In contrast, 50% to 88% of this patient population have sleep problems [16].…”

Depressive Symptoms Are Associated With Decreased Quality of Life and Work Ability in Currently Working Health Care Workers With Recurrent Low Back Pain

“…Understanding the impact of depressive symptoms and depression is important to clinical management of LBP. Patients with subacute LBP and depression will need psychological care in addition to medical or physiotherapy treatment 40–42 …”

“…Patients with subacute LBP and depression will need psychological care in addition to medical or physiotherapy treatment. [40][41][42]…”