Depression Impacts the Course of Recovery in Patients with Acute Low-Back Pain

Abstract

Little is known about the course of recovery of acute low back pain (LBP) patients as a function of depression. In a prospective study, 286 acute LBP patients were assessed at baseline and followed up over 6 months. Recovery was defined as improvement in the Oswestry Disability Index (ODI). Repeated-measures analysis of covariance was employed with ODI as repeated factor, age, sex, and body mass index as covariates, depression and all other potential prognostic factors as between-subject factors. Of study participants, 18% were classified as depressive (>33 points on the Zung Self-Rating Depression Scale). Of 286 participants, 135 were lost to follow-up. In the longitudinal sample of 151 patients the course of recovery was slower in depressive patients. Depression was associated with LBP especially after 6 weeks and should therefore be included in screening instruments for acute LBP patients to identify those at risk of delayed recovery at an early stage.

Keywords:

• acute back pain
• depression
• prognosis
• prospective study recovery

ACKNOWLEDGMENTS

This research was supported by the New Zealand Orthopaedic Association (NZOA) Trust, Wellington; the Wishbone Trust of New Zealand, Wellington; Lottery Health Research, Wellington; the Bruce McMillan Trust, Dunedin; the Dunedin School of Medicine; realHealth International, Hitzkirch and the University of Berne.