Psychiatric disorders and risk of transition to chronicity in men with first onset low back pain.
Pain Med
; 11(9): 1391-400, 2010 Sep.
Article
en En
| MEDLINE
| ID: mdl-20735749
ABSTRACT
OBJECTIVE:
To assess whether pre-existing psychiatric diagnoses increase the likelihood of transitioning from sub-acute to chronic back pain.DESIGN:
Prospective cohort study.METHODS:
Men (N = 140) experiencing a first onset of low back pain (LBP) were examined for lifetime psychiatric disorders approximately 8 weeks post pain-onset using the Diagnostic Interview Schedule (DIS-III-R), then re-evaluated at 6 months after pain onset to determine who did or did not progress to pain chronicity. OUTCOMEMEASURE:
Transition to chronic pain and disability was based on 6-month self-report measures of pain intensity and perceived disability.RESULTS:
Men with a pre-pain lifetime diagnosis of major depressive disorder had 5 times greater risk of transitioning to chronic LBP (odds ratio [OR] = 4.99; 95% confidence interval [CI] 1.49-16.76). Increased risk was also associated with a pre-pain lifetime diagnosis of generalized anxiety (OR = 2.45; 95% CI 1.06-5.68), post-traumatic stress (OR = 3.23; 95% CI 1.11-9.44), and with current nicotine dependence (OR = 2.49; 95% CI 1.15-5.40). There were no statistically significant effects for abuse or dependence of alcohol or other psychoactive substances.DISCUSSION:
Lifetime history of major depression or a major anxiety disorder may represent potential psychosocial "yellow flags" for the transition to chronicity in men with first-onset LBP. Screening for lifetime depressive or anxiety disorders may identify individuals at higher risk, who may benefit from referral for more intensive rehabilitation.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Enfermedad Crónica
/
Dolor de la Región Lumbar
/
Trastornos Mentales
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Pain Med
Asunto de la revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
Año:
2010
Tipo del documento:
Article
País de afiliación:
Estados Unidos