Stubbs Brendon, Koyanagi Ai, Thompson Trevor, Veronese Nicola, Carvalho Andre F, Solomi Marco, Mugisha James, Schofield Patricia, Cosco Theodore, Wilson Nicky, Vancampfort Davy
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
Research and Development Unit, ParcSanitariSant Joan de Déu, Universitat de Barcelona, FundacióSant Joan de Déu, Dr. Antoni Pujadas, 42, SantBoi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de InvestigaciónBiomédicaen Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain.
Gen Hosp Psychiatry. 2016 Nov-Dec;43:63-70. doi: 10.1016/j.genhosppsych.2016.09.008. Epub 2016 Sep 30.
Back pain (BP) is a leading cause of global disability. However, population-based studies investigating its impact on mental health outcomes are lacking, particularly among low- and middle-income countries (LMICs). Thus, the primary aims of this study were to: (1) determine the epidemiology of BP in 43 LMICs; (2) explore the relationship between BP and mental health (depression spectrum, psychosis spectrum, anxiety, sleep disturbances and stress).
Data on 190,593 community-dwelling adults aged ≥18 years from the World Health Survey (WHS) 2002-2004 were analyzed. The presence of past-12 month psychotic symptoms and depression was established using questions from the Composite International Diagnostic Interview. Anxiety, sleep problems, stress sensitivity, and any BP or chronic BP (CBP) during the previous 30 days were also self-reported. Multivariable logistic regression analyses were undertaken.
The overall prevalence of any BP and CBP were 35.1% and 6.9% respectively. Significant associations with any BP were observed for subsyndromal depression [OR (odds ratio)=2.21], brief depressive episode (OR=2.64), depressive episode (OR=2.88), psychosis diagnosis with symptoms (OR=2.05), anxiety (OR=2.12), sleep disturbance (OR=2.37) and the continuous variable of stress sensitivity. Associations were generally more pronounced for chronic BP.
Our data establish that BP is associated with elevated mental health comorbidity in LMICs. Integrated interventions that address back pain and metal health comorbidities might be an important next step to tackle this considerable burden.
背痛是全球残疾的主要原因。然而，缺乏基于人群的研究来调查其对心理健康结果的影响，特别是在低收入和中等收入国家（LMICs）。因此，本研究的主要目的是：（1）确定43个低收入和中等收入国家背痛的流行病学情况；（2）探讨背痛与心理健康（抑郁谱系、精神病谱系、焦虑、睡眠障碍和压力）之间的关系。
分析了2002 - 2004年世界卫生调查（WHS）中190,593名年龄≥18岁的社区居住成年人的数据。使用综合国际诊断访谈中的问题确定过去12个月内是否存在精神病症状和抑郁症。焦虑、睡眠问题、压力敏感性以及前30天内的任何背痛或慢性背痛（CBP）也通过自我报告获得。进行了多变量逻辑回归分析。
任何背痛和慢性背痛的总体患病率分别为35.1%和6.9%。观察到亚综合征性抑郁[比值比（OR）=2.21]、短暂抑郁发作（OR = 2.64）、抑郁发作（OR = 2.88）、有症状的精神病诊断（OR = 2.05）、焦虑（OR = 2.12）、睡眠障碍（OR = 2.37）以及压力敏感性连续变量与任何背痛之间存在显著关联。慢性背痛的关联通常更为明显。
我们的数据表明，在低收入和中等收入国家，背痛与心理健康合并症的增加有关。解决背痛和心理健康合并症的综合干预措施可能是应对这一巨大负担的重要下一步。
