Abstract
Objective
To characterize the measurement scales and levels of psychological distress reported
among published studies of acute low back pain (LBP) in the scientific literature.
Data Sources
Peer-reviewed scientific literature found in 8 citation index search engines (CINAHL,
Embase, MANTIS, PsycINFO, PubMed, Web of Science, AMED, and Academic Search Premier)
for the period from January 1, 1966, to April 30, 2015, in English, Danish, Norwegian,
and Swedish languages.
Study Selection
Cross-sectional, case-control, cohort, or randomized controlled trials assessing psychological
distress and including participants drawn from patients and workers (or an identifiable
subset) with acute LBP (<8wk). Three researchers independently screened titles, abstracts,
and full-length articles to identify peer-reviewed studies according to established
eligibility criteria.
Data Extraction
Descriptive data (study populations, definitions of LBP, distress measures) were systematically
extracted and reviewed for risk of bias. Distress measures were described, and data
were pooled in cases of identical measures. Reported levels of distress were contextualized
using available population norms, clinical comparison groups, and established clinical
cutoff scores.
Data Synthesis
Of 10,876 unique records, 23 articles (17 studies) were included. The most common
measures were the Beck Depression Inventory, the modified version of the Zung Self-Rated
Depression Scale, the Center for Epidemiologic Studies-Depression Scale, and the Medical
Outcomes Study 12-Item Short-Form Health Survey and Medical Outcomes Study 36-Item
Short-Form Health Survey. Pooled results for these scales showed consistent elevations
in depression, but not anxiety, and reduced mental health status in comparison with
the general population.
Conclusions
Based on the high consistency across studies using valid measures with a low to moderate
risk of bias, there is strong evidence that psychological distress is elevated in
acute LBP.
Keywords
List of abbreviations:
BDI (Beck Depression Inventory), CES-D (Center for Epidemiologic Studies-Depression), CI (confidence interval), LBP (low back pain), SF-12 (Medical Outcomes Study 12-Item Short-Form Health Survey), SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey), ZSRDS (Zung Self-Rating Depression Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 24, 2016
Footnotes
Supported by a guest scientist grant from Liberty Mutual Research Institute for Safety; intramural funding of the Liberty Mutual Research Institute for Safety provided partial salary, technical, and administrative support for the systematic review (#LMRIS 12-05).
PROSPERO International Prospective Register of Systematic Reviews Protocol Registration No.: CRD42013005752.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
