Department of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Department of Orthopedics, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan.
BMC Musculoskelet Disord. 2023 Jul 11;24(1):565. doi: 10.1186/s12891-023-06682-6.
No previous study has investigated the associations of depression, anxiety, and insomnia at baseline with disability at a five-year follow-up point among outpatients with chronic low back pain (CLBP). The study aimed to simultaneously compare the associations of depression, anxiety, and sleep quality at baseline with disability at a 5-year follow-up point among patients with CLBP.
Two-hundred and twenty-five subjects with CLBP were enrolled at baseline, and 111 subjects participated at the five-year follow-up point. At follow-up, the Oswestry Disability Index (ODI) and total months of disability (TMOD) over the past five years were used as the indices of disability. The depression (HADS-D) and anxiety (HADS-A) subscales of the Hospital Anxiety and Depression Scale and the Insomnia Severity Index (ISI) were used to assess depression, anxiety, and insomnia at baseline and follow-up. Multiple linear regression was employed to test the associations.
The scores of the HADS-D, HADS-A, and ISI were correlated with the ODI at the same time points (both at baseline and follow-up). A greater severity on the HADS-D, an older age, and associated leg symptoms at baseline were independently associated with a greater ODI at follow-up. A greater severity on the HADS-A and fewer educational years at baseline were independently associated with a longer TMOD. The associations of the HADS-D and HADS-A at baseline with disability at follow-up were greater than that of the ISI at baseline, based on the regression models.
Greater severities of depression and anxiety at baseline were significantly associated with greater disability at the five-year follow-up point. The associations of depression and anxiety at baseline with disability at the long-term follow-up point might be greater than that of insomnia at baseline.
此前尚无研究调查慢性下腰痛（CLBP）门诊患者基线时的抑郁、焦虑和失眠与五年随访时的残疾之间的关系。本研究旨在同时比较基线时的抑郁、焦虑和睡眠质量与 CLBP 患者五年随访时的残疾之间的关系。
225 例 CLBP 患者在基线时入组，其中 111 例在五年随访时参加。在随访时，采用 Oswestry 残疾指数（ODI）和过去五年的总残疾月数（TMOD）作为残疾指标。采用医院焦虑和抑郁量表的抑郁（HADS-D）和焦虑（HADS-A）分量表以及失眠严重程度指数（ISI）来评估基线和随访时的抑郁、焦虑和失眠。采用多元线性回归来检验关联。
HADS-D、HADS-A 和 ISI 的分数与同一时间点的 ODI 呈相关（均为基线和随访时）。基线时 HADS-D 评分较高、年龄较大以及伴有腿部症状与随访时 ODI 较高独立相关。基线时 HADS-A 评分较高和受教育年限较少与 TMOD 较长独立相关。基于回归模型，基线时 HADS-D 和 HADS-A 与随访时残疾的关联大于基线时 ISI 的关联。
基线时抑郁和焦虑的严重程度与五年随访时的残疾显著相关。基线时抑郁和焦虑与长期随访时残疾的关联可能大于基线时失眠的关联。
