抑郁症与 50 岁以上慢性下腰痛患者密切相关：使用第六次韩国国家健康和营养检查调查（KNHANES VI-2）的横断面研究。

Depression is Closely Associated With Chronic Low Back Pain in Patients Over 50 Years of Age: A Cross-sectional Study Using the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-2).

机构信息

Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Sungnam, Republic of Korea.

Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Korea.

出版信息

Spine (Phila Pa 1976). 2018 Sep 15;43(18):1281-1288. doi: 10.1097/BRS.0000000000002595.

DOI:10.1097/BRS.0000000000002595

PMID:29462063

Abstract

STUDY DESIGN

A cross-sectional study.

OBJECTIVE

This study was designed to analyze the relationship between the presence and severity of depression and low back pain (LBP) in a representative sample of the general population using a self-report screening questionnaire for depression.

SUMMARY OF BACKGROUND DATA

There is increasing evidence supporting an association between depression and LBP. However, the degree of the association between these two conditions in the general population is poorly understood.

METHODS

Health surveys and examinations were conducted on a nationally representative sample (n = 7550) of Koreans. LBP status was determined by a simple survey response concerning LBP >30 days during the past 3 months. Depression was defined as individuals with a total score >10 on the Patient Health Questionnaire (PHQ)-9 survey. The severity of depression was categorized as none (0-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe (20-27) according to PHQ-9 score. Data regarding demographics, socioeconomic history, and comorbid health conditions were used to analyze adjusted, weighted logistic regression models.

RESULTS

In the Korean population, the prevalence of depression was significantly greater in individuals with LBP (20.3%) than in those without LBP (4.5%). On multivariate logistic regression analysis, the presence of depression was significantly associated with LBP (adjusted odd ratio [aOR]: 3.93, P < 0.001). The risk of LBP increased with increasing severity of depression as follows: severe depression (aOR: 9.28, P < 0.001), moderately severe depression (aOR: 3.24, P = 0.001), moderate depression (aOR: 4.97, P < 0.001), and mild depression (aOR: 2.48, P < 0.001).

CONCLUSION

Depression is more common in patients with LBP among Koreans. The presence of depression was significantly associated with LBP, especially in severely depressed individuals.

LEVEL OF EVIDENCE

摘要

研究设计

横断面研究。

目的

本研究旨在使用抑郁自评筛查问卷分析代表性普通人群中抑郁与腰痛（LBP）之间的存在和严重程度的关系。

背景资料总结

越来越多的证据支持抑郁与 LBP 之间存在关联。然而，普通人群中这两种情况之间关联的程度尚不清楚。

方法

对韩国全国代表性样本（n=7550）进行健康调查和体检。通过对过去 3 个月中 LBP 持续时间超过 30 天的简单调查应答来确定 LBP 状态。抑郁的定义为患者健康问卷（PHQ-9）总得分＞10 分。根据 PHQ-9 得分，将抑郁严重程度分为无（0-4）、轻度（5-9）、中度（10-14）、中重度（15-19）和重度（20-27）。使用人口统计学、社会经济史和合并健康状况的数据来分析调整后、加权逻辑回归模型。

结果

在韩国人群中，有 LBP 的个体中抑郁的发生率明显高于无 LBP 的个体（20.3%比 4.5%）。在多变量逻辑回归分析中，存在抑郁与 LBP 显著相关（调整后比值比[aOR]：3.93，P＜0.001）。随着抑郁严重程度的增加，LBP 的风险增加如下：重度抑郁（aOR：9.28，P＜0.001）、中重度抑郁（aOR：3.24，P=0.001）、中度抑郁（aOR：4.97，P＜0.001）和轻度抑郁（aOR：2.48，P＜0.001）。