More data on major depression as an antecedent risk factor for first onset of chronic back pain.
BACKGROUND
Few epidemiological studies have examined the temporal relationship between chronic pain and depression using longitudinal data. In the present study, we examined major depression as both an antecedent risk factor and consequence of chronic back pain (CBP) in the general population.


METHODS
Data on 9909 pain-free individuals 15 years and older with no history of back problems were drawn from cycle 1 of the National Population Health Survey and followed up 24 months later. Major depression was assessed using a structured diagnostic interview.


RESULTS
At cycle 2, the rate of new cases of CBP in persons who were depressed at cycle 1 was 3.6% compared to 1.1% in non-depressed persons. Compared to pain-free individuals, new cases of CBP were more likely to perceive their health status as poor or fair at cycle 1, were less likely to be working, reported more chronic health problems, and sustained a back or neck injury in the preceding 12 months. After controlling for other factors, pain-free individuals diagnosed as major depressed at cycle 1 were almost three times more likely (OR 2.9, 95% CI 1.2-7.0) to develop CBP at cycle 2.


CONCLUSIONS
Consistent with other longitudinal studies major depression increases the risk of developing future chronic pain. The causal mechanism linking these conditions is unknown however depression may represent a modifiable risk factor in the development of CBP.
Currie
Shawn R
SR
Addiction Centre, Foothills Medical Centre, Calgary, CanadaUniversity of Calgary, Canada. scurrie@ucalgary.ca
Wang
Jianli
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000523:psychology*; D002908:Chronic Disease; D003865:Major Depressive Disorder / Q000150:complications*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors