title: Comparison of mental distress in patients with low back pain and a population-based control group measured by Symptoms Check List--A case-referent study.
abstract: OBJECTIVE
  Mental distress is common in persons experiencing low back pain and who are sick-listed or at risk of being sick-listed. It is, however, not known how mental distress measured by the Symptoms Check List-90 differs between patients with low back pain and the general population. The objective of this study was to compare mental symptoms and distress as measured by the Symptoms Check List-90 in sick-listed or at risk of being sick-listed patients with low back pain with a population-based control group.
  
  
  METHODS
  Mental distress was compared in a group of patients with low back pain (n=770) and a randomly selected population-based reference group (n=909). Established Danish cut-off values for mental distress were used to evaluate the mental distress status in the low back pain and control group and logistic regression was used to calculate odds ratios for the Global Severity Index and the symptom scales of the Symptoms Check List-90 while controlling for baseline demographic differences between the groups.
  
  
  RESULTS
  Group mean scores showed that all symptom scales and the Global Severity Index for both sexes were statistically elevated in the low back pain group, except for interpersonal sensitivity in women. When the scores were dichotomized to cases and non-cases of mental distress, a significantly higher prevalence of cases was observed in the low back pain group compared to the reference group on all symptom check list scales, except for paranoid ideation for both sexes and interpersonal sensitivity for women. The biggest between-group difference was observed for the somatization symptom scale.
  
  
  CONCLUSIONS
  Low back pain patients who are sick-listed or at risk of being sick-listed, are more mentally distressed compared to a randomly selected sample of the general Danish population. Self-reported symptoms of somatization, anxiety, phobic anxiety, obsessive-compulsive, depression and hostility are all more common among patients with low back pain compared to the general population.
authors.affiliation: CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health, University of Copenhagen, Denmark fysjan@gmail.com.
authors.forename: Jan
authors.initials: J
authors.lastname: Christensen
authors.affiliation: CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health, University of Copenhagen, Denmark.
authors.forename: Annette
authors.initials: A
authors.lastname: Fisker
authors.affiliation: Institute of Public Health and Center for Healthy Aging, University of Copenhagen, Denmark.
authors.forename: Erik Lykke
authors.initials: EL
authors.lastname: Mortensen
authors.affiliation: Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark.
authors.forename: Lis Raabæk
authors.initials: LR
authors.lastname: Olsen
authors.affiliation: Department of Occupational Medicine, University Hospital Køge, Denmark.
authors.forename: Ole Steen
authors.initials: OS
authors.lastname: Mortensen
authors.affiliation: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark and Nordic Institute of Chiropractic and Clinical Biomechanics, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Hartvigsen
authors.affiliation: CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health, University of Copenhagen, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Langberg
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D018582:Sick Leave / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
keywords: Low back pain; mental health; occupational health; somotoform disorders; stress psychological