CC BY-NC-ND 4.0 · Avicenna J Med 2021; 11(03): 145-151
DOI: 10.1055/s-0041-1734385
Original Article

Do Patients of Chronic Low Back Pain have Psychological Comorbidities?

Kritika Singhal
1  Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
,
Krishna Prasad Muliyala
1  Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
,
Abhijit P. Pakhare
2  Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
,
Prateek Behera
3  Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
,
John Ashutosh Santoshi
3  Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
› Author Affiliations

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.



Publication History

Publication Date:
06 September 2021 (online)

© 2021. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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