The impact of depression among chronic low back pain patients in Japan.
The impact of depression among chronic low back pain patients in Japan.
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DOI：
10.1186/s12891-016-1304-4
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发表时间：
2016-10-27
影响因子：
2.3
通讯作者：
Vietri J
中科院分区：
文献类型：
--
作者：
Tsuji T;Matsudaira K;Sato H;Vietri J
慢性腰痛（CLBP）与严重残疾和健康相关生活质量（HRQoL）降低相关，这可能对整体功能和生产力产生负面影响。抑郁症也与疼痛的身体症状有关，并且通常存在于慢性疼痛患者中。然而，CLBP患者中与抑郁或抑郁症状相关的增量负担尚未得到很好的理解。本研究的目的是调查抑郁症对CLBP患者HRQoL的影响，并评估日本CLBP患者抑郁症与工作障碍和医疗保健使用之间的关系。数据来自2014年日本国民健康调查（N = 30，000）。CLBP定义为报告诊断的腰痛持续时间≥3个月。使用患者健康问卷（PHQ-9）评估抑郁症。评估的指标包括疼痛，HRQoL，劳动力参与，工作效率和医疗保健利用率。对抑郁症患者（PHQ-9 ≥ 10）和非抑郁症患者（PHQ-9 < 10）进行比较，连续变量和计数变量采用t检验，分类变量采用卡方检验，随后采用广义线性模型校正协变量。使用非参数相关性（斯皮尔曼rho）分析出勤率与其他患者结局和特征之间的相关性。与无抑郁症的患者相比，抑郁的CLBP患者的疼痛明显更严重，疼痛程度更高（P < 0.001）。抑郁与CLBP患者的HRQoL较差相关。与无抑郁症的人相比，抑郁症患者的存在主义、总体工作障碍和活动障碍分别高出1.8、1.9和1.7倍。患有抑郁症的CLBP患者在6个月内访问医疗保健提供者的次数几乎是没有抑郁症的患者的两倍。调整社会人口学和一般健康特征后，结果的模式保持一致。分析还表明，出勤率密切相关的整体工作障碍（rho = 0.99）。日本CLBP患者的抑郁症与较高的疼痛评分和较低的HRQoL评分以及较低的劳动生产率和增加的医疗保健使用相关。CLBP患者的抑郁症筛查应该是CLBP患者护理的重要组成部分。
Chronic low back pain (CLBP) is associated with significant disability and reductions in health related quality of life (HRQoL), which can negatively impact overall function and productivity. Depression is also associated with painful physical symptoms, and is often present in patients with chronic pain. However, the incremental burden associated with depression or symptoms of depression among CLBP patients is not well understood. The objective of this study was to investigate the impact of depression on HRQoL in CLBP and to assess the relationship between depression and work impairment and healthcare use among CLBP patients in Japan. Data were extracted from the 2014 Japan National Health and Wellness Survey (N = 30,000). CLBP was defined by report of diagnosed low back pain ≥3 months duration. Depression was assessed using the Patient Health Questionnaire (PHQ-9). Measurements assessed included pain, HRQoL, labor force participation, work productivity and healthcare utilization. Patients with depression (PHQ-9 ≥ 10) were compared to patients without depression (PHQ-9 < 10) using t-tests for continuous and count variables and chi-square for categorical variables, which were followed by generalized linear models adjusted for covariates. The association between presenteeism and other patient outcomes and characteristics was analysed using nonparametric correlations (Spearman’s rho). Depressed CLBP patients had significantly more severe pain and higher levels of pain compared with patients without depression (P < 0.001). Depression was associated with worse HRQoL in CLBP patients. Presenteeism, overall work impairment and activity impairment were 1.8, 1.9 and 1.7 times as high, respectively, among those with depression relative to those without depression. CLBP patients with depression had almost twice as many healthcare provider visits in 6 months than those without depression. The pattern of results remained consistent after adjustment for sociodemographic and general health characteristics. Analysis also indicated presenteeism was closely related to overall work impairment (rho = 0.99). Depression among CLBP patients in Japan was associated with higher pain scores and lower HRQoL scores, as well as lower labor productivity and increased healthcare use. Screening for depression in CLBP patients should be an essential part of CLBP patient care.
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影响因子：
7.2
作者：
Suzukamo, Yoshimi;Fukuhara, Shunichi;Ware, John E.
通讯作者：
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影响因子：
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作者：
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影响因子：
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