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A global analysis has found that people diagnosed with chronic back pain were 3 times more likely to experience a depressive episode and 2,5 times more likely to experience psychotic symptoms.

Back pain is known to be a leading cause of disability and affects 1 in 10 people worldwide, more than any other condition. Back pain negatively impacts a person's quality of life and increases the risk of developing other physical health-related problems. What hasn't been researched though, is what impact back pain has on the mental health of patients, especially from low and middle income countries diagnosed with this condition.

Therefore, researchers conducted a study with the aim to discover the epidemiology of back pain in 43 low and middle income countries (LMICs), and to investigate whether a relationship exists between back pain and mental health conditions including the depression spectrum, stress, the psychosis spectrum, sleep disturbances and anxiety.

The study

A research team from Anglia Ruskin University in the UK searched through data from the World Health Survey of 2002-2004 that included nearly 191,000 patients, from 18 years and older, and who were from 43 countries (19 low-income and 24 middle-income).

The findings

When the data was analyzed, the following findings were made:

  • Back pain affected just over 35% of the population of these LMICs, with nearly 7% reporting chronic back pain. The lowest levels of back pain were reported by China with nearly 14% of the population being affected.
  • Nepal reported the highest percentage of patients complaining of back pain at just over 57% of the population, Bangladesh with over 53% of their population and Brazil reporting back pain affecting 52% of their population. What was astonishing about this finding was that more than half of these country's citizens complained of back pain.
  • It was discovered, on analysis of the questionnaire data, that patients who experienced back pain were two times more likely than those who didn't complain of back pain to experience mental health issues such as depression, anxiety, stress, psychosis or sleep deprivation.
  • Individuals diagnosed with chronic back pain were three times more likely to experience a depressive episode and over 2,5 times more likely to experience psychotic symptoms.
  • These results seemed to be reproduced in all the 43 LMICs irrespective of socio-economic standings.

The clinical significance

Seeing that this study used data from such a large population group from countries all over the world, it would be fair to say that these findings are highly reliable. It would also be fair to say that since back pain is such a prevalent condition worldwide, that any link to mental health issues needs to be paid attention to, thoroughly understood and managed accordingly.

Health care professions are then urged to assess the patient's needs who come complaining of back pain, as this issue not only causes physical problems but psychiatric complications, too. Management protocols combining the treatment of both back pain and mental health conditions need to be incorporated for these patients and further research is needed into these aspects.
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