ANXIETY AND DEPRESSION IN PATIENTS SUFFERING FROM CHRONIC LOW BACKACHE

Chronic Low Backache

Abstract

Objective: To determine the frequency of anxiety and depression in patients with chronic low backache and to document other co-morbidities among these patients presenting at rheumatology clinic of a tertiary care hospital in Islamabad.
Study Design: Cross sectional study.
Place and Duration of Study: Study was conducted at Pakistan Institute of Medical Sciences from July 2012 to April 2013.
Methodology: A total of 170 chronic low backache patients were administered urdu translated Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scales. Scoring was done on Likert-type scale of 1-4 (based on these replies: "a little of the time," "some of the time," "good part of the time," "most of the time") with overall assessment by cumulative score ranging from 20 to 80, where 20-44 was normal range, 45-59 mildly depressed/anxious, 60-69 moderately depressed / anxious and 70 and above severely depressed / anxious.
Results: Out of 170 patients, 157 patients above 18 years of age with male to female ratio 2:3 completed the study. Among study sample 72.2% had mild depression, 21.6% had mild anxiety, 32% had mixed mild anxiety and depression, 0.8% had severe depression, 1.6% had severe anxiety while 2.4% suffered from severe mixed symptoms. Overall, 125 (79.6%) patients were suffering from mild to severe form of depression and anxiety both alone or mixed. Obesity was present in 34 (21.66%) of patients with chronic backache and out of these 29 (85.3%) had psychological co-morbidity.
Conclusion: Two thirds of the chronic backache patients reporting at rheumatology clinic of a tertiary care hospital were suffering from mild to severe degree of depression and anxiety. This worrying situation calls for thorough systematic evaluation of all chronic backache patients arriving at rheumatology clinic for mood disorders and psychological ailment.