Article

Clinical guidelines advocate the routine identification of depressive
symptoms for patients with pain in the lumbar or cervical spine, but not for
other anatomical regions. The purpose of this study was to investigate
the prevalence and impact of depressive symptoms for patients with
musculoskeletal pain across different anatomical regions. Design This was a
prospective, associational study. METHODS: Demographic, clinical, depressive
symptom (Symptom Checklist 90-Revised), and outcome data were collected by
self-report from a convenience sample of 8,304 patients. Frequency of severe
depressive symptoms was assessed by chi-square analysis for demographic and
clinical variables. An analysis of variance examined the influence of depressive
symptoms and anatomical region on intake pain intensity and functional status.
Separate hierarchical multiple regression models by anatomical region examined
the influence of depressive symptoms on clinical outcomes. RESULTS: Prevalence of
severe depression was higher in women, in industrial and pain clinics, and in
patients who reported chronic pain or prior surgery. Lower prevalence rates were
found in patients older than 65 years and those who had upper- or lower-extremity
pain. Depressive symptoms had a moderate to large effect on pain ratings (Cohen
d=0.55-0.87) and a small to large effect on functional status (Cohen
d=0.28-0.95). In multivariate analysis, depressive symptoms contributed
additional variance to pain intensity and functional status for all anatomical
locations, except for discharge values for the cervical region. CONCLUSIONS:
Rates of depressive symptoms varied slightly based on anatomical region of
musculoskeletal pain. Depressive symptoms had a consistent detrimental influence
on outcomes, except on discharge scores for the cervical anatomical region.
Expanding screening recommendations for depressive symptoms to include more
anatomical regions may be indicated in physical therapy settings.

Langue : ANGLAIS