Petrelis Matthaios, Soultanis Konstantinos, Michopoulos Ioannis, Nikolaou Vasileios
Medical School, National and Kapodistrian University of Athens, Greece.
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
Psychiatriki. 2023 Oct 12;34(3):221-230. doi: 10.22365/jpsych.2023.005. Epub 2023 Feb 10.
Literature findings have suggested that psychological factors, including anxiety, depression and somatic symptom disorder (SSD), are predictors of poor outcomes in individuals with chronic low back pain (CLBP). The aim of this study was to examine the correlations between anxiety, depression and SSD with pain, disability and health-related quality of life (HRQoL) in Greek CLBP patients. Ninety-two participants with CLBP recruited using random systematic sampling from an outpatient physiotherapy department, who completed a battery of paper-and-pencil questionnaires included items on demographic characteristics, as well the Numerical Pain Rating Scale (NPRS) for pain, the Rolland-Morris Disability Questionnaire for disability (RMDQ), the EuroQoL 5-dimension 5-level (EQ-5D-5L) for health status, the Somatic Symptom Scale-8 (SSS-8) for SSD, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression. A Mann-Whitney test and a Kruskall-Wallis test were used for the comparison of continuous variables between two groups and among more than two groups, respectively. Moreover, Spearman correlations coefficients were used to explore the association between subjects' demographics, SSS-8, HADS-Anxiety, HADS-Depression, NPS, RMDQ and EQ-5D-5L indices. Predictors of health status, pain and disability were assessed using multiple regression analyses, whereas the level of statistical significance was set at p<0.05. The response rate was 94.6% (87 participants, 55 of whom were women) and the mean age of the sample was 59.6 years (SD=15.1). A tendency of weak negative associations was noted between scores of SSD, anxiety and depression with EQ-5D-5L indices, whereas only a weak positive correlation was found between levels of SSD with pain and disability. After examining in a multiple regression analysis, only SSD emerged as prognostic factor of poor HRQoL, greater levels of pain and disability. In conclusion, the elevated scores of SSD significantly predict worse HRQoL, intense pain and severe disability in Greek CLBP patients. Further research is needed to test our findings in larger and more representative samples of the Greek general population.
文献研究结果表明，心理因素，包括焦虑、抑郁和躯体症状障碍（SSD），是慢性下腰痛（CLBP）患者预后不良的预测因素。本研究的目的是探讨希腊CLBP患者中焦虑、抑郁和SSD与疼痛、残疾及健康相关生活质量（HRQoL）之间的相关性。采用随机系统抽样方法从门诊理疗科招募了92名CLBP患者，他们完成了一系列纸质问卷，包括人口统计学特征项目，以及用于评估疼痛的数字疼痛评分量表（NPRS）、用于评估残疾的罗兰-莫里斯残疾问卷（RMDQ）、用于评估健康状况的欧洲五维健康量表（EQ-5D-5L）、用于评估SSD的躯体症状量表-8（SSS-8）、用于评估焦虑和抑郁的医院焦虑抑郁量表（HADS）。分别使用曼-惠特尼检验和克鲁斯卡尔-沃利斯检验来比较两组之间以及两组以上之间的连续变量。此外，使用斯皮尔曼相关系数来探讨受试者的人口统计学特征、SSS-8、HADS焦虑量表、HADS抑郁量表、NPS、RMDQ和EQ-5D-5L指数之间的关联。使用多元回归分析评估健康状况、疼痛和残疾的预测因素，而统计学显著性水平设定为p<0.05。应答率为94.6%（87名参与者，其中55名是女性），样本的平均年龄为59.6岁（标准差=15.1）。注意到SSD、焦虑和抑郁得分与EQ-5D-5L指数之间存在弱负相关趋势，而SSD水平与疼痛和残疾之间仅发现弱正相关。在多元回归分析中进行检验后，只有SSD成为HRQoL较差、疼痛和残疾程度较高的预后因素。总之，SSD得分升高显著预测希腊CLBP患者的HRQoL较差、疼痛剧烈和残疾严重。需要进一步研究以在希腊普通人群中更大且更具代表性的样本中验证我们的研究结果。
