Psychiatric Morbidity in Chronic Low Back Pain-A Cross-Sectional Study
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 7
Abstract
Introduction: Psychiatric disorders are found to be predisposing or perpetuating factors in patients with Chronic Low Back Pain (CLBP) and these may also arise as a consequence of CLBP. More than one third of patients with CLBP are reported to have psychiatric morbidity along with physical or radiological signs and another third has no physical or radiological signs, but only psychiatric disorders. On the basis of clinical and radiological findings and presence of psychiatric diagnosis, patients with CLBP can be grouped in to three: 1) those with psychiatric disorder alone- the psychiatric group; 2) those with only physical illness with no psychiatric disorder- the organic group; and 3) group with both physical illness with psychiatric disorder-the combined group. Prevalence of psychiatric disorders in CLBP is understudied. Identification and treatment of psychiatric disorders in CLBP will help to reduce disability. Aim: To assess the type of psychiatric disorders and to compare psychiatric disorders between psychiatric, non-psychiatric and combined group of CLBP. Materials and Methods: This was a cross-sectional observational study conducted in 92 consecutive patients presented with CLBP (back pain lasting for more than 12 weeks duration) to outpatient orthopaedics department during April to September 2001. These patients were evaluated for physical disorders using clinical and radiological examinations and psychiatric disorders using ICD 10 Classification of Mental and Behavioural Disorder-Diagnostic Criteria for Research (DCR). On the basis of clinical and radiological findings and presence of psychiatric diagnosis, subjects were grouped in to three; psychiatric group, organic group and the combined group. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 16.0. Sociodemographic and clinical characteristics between the groups were compared using Chi-square test for categorical variables and ANOVA for continuous variables. Results: Of 92 subjects 45(48.9%) belonged to the combined group, 38(41.3%) to psychiatric group and 9(9.8%) to organic disorder group. Depressive disorder was significantly higher (p=0.01) but somatoform disorder was significantly lower in combined group (p<0.01) compared to psychiatric group. There were more patients with severe pain in psychiatric group compared to other two groups (p<0.05). Conclusion: Psychiatric disorders are highly prevalent in CLBP. Proper and timely identification of psychiatric disorders may help clinicians to judiciously select the treatment in CLBP.
Authors and Affiliations
Anithakumari Ayirolimeethal, Firozka Zhungil, A. M Kunhikoyamu, V Ravikumar
Efficacy of Calendula officinalis Extract (Marigold Flower) as an Antimicrobial Agent against Oral Microbes: An Invitro Study in Comparison with Chlorhexidine Digluconate
Introduction: Calendula officinalis is a member of the family Asteraceae containing flavonoids, and essential oils etc. It is known to be effective against certain gram negative and gram positive clinical pathogens. Inco...
Does Selection and Management of Patients with Chronic Kidney Disease In Government Run and Private Hospitals Differ?
Introduction: Globally, incidence of Chronic Kidney Disease (CKD) is rapidly rising with huge burden on the life expectancy of the patients. Regular haemodialysis improves the quality of life in these patients. They get...
Case of Antenatal Splenic Rupture: Managed Conservatively
ABSTRACT Splenic laceration antepartum or postpartum is a rare, frequently misdiagnosed and potentially catastrophic pathology that can lead to high maternal and fetal mortality and morbidity. It is therefore, imperative...
Role of CD10 Immunoexpression in Grading Phyllodes Tumour of the Breast
Introduction: Fibroepithelial tumours are a heterogeneous group of biphasic neoplasms consisting of a proliferation of both epithelial and stromal components. Fibroadenoma (FA) and Phyllodes Tumour (PT) constitute the ma...
Effect of Botulinum Toxin Type A on Functional Mobility in Cerebral Palsy with Lower Limb Spasticity
ABSTRACT Introduction: Children with Cerebral Palsy (CP) often start walking much later than typically developing children and they do so with a slower speed and higher energy cost. Mobility varies across different envir...