Medically Unexplained Physical Symptoms with Masked Depression: A Case of Intractable Low Back Pain

Chen, Jian Ting; Hsu, Chia Yueh; Lee, Yue Joe; Tseng, Ming-Yuan; Liao, Shih‐Cheng

doi:10.1016/s0929-6646(07)60013-8

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…After further careful abstracts viewing, 84 studies with full-text publications were retrieved for detailed assessment. After eliminating 62 papers with unrelated or ambiguous results, 22 papers were further analyzed in detail (14–16, 23–41). Table 1 lists the abstract items of the final 22 papers, including publication year, design, country or region, sample size, source of study sample, outcomes, adjusted matched factors, and quality assessment score.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, if this relationship is bidirectional and if obesity indeed influences the risk of thyroid disorders, it is still incompletely elucidated how obesity influences the risk of thyroid dysfunctions and impacts the risk of thyroid autoimmunity. Although some studies have reported that obesity may be associated with dysfunctions of thyroid immunity and thyroid gland (14–16), these results are not entirely the same and even controversial. In addition, some of these studies have a relatively small sample size.…”

Section: Introductionmentioning

confidence: 98%

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The Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis

et al. 2019

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Background: To help inform decision making in the clinical setting, we carried out a systematic review and meta-analysis to estimate the association of thyroid disease risks with obesity.Methods: Pubmed, Embase, Web of Science, Cochrane database and Google Scholar electronic databases were searched from inception to October 31, 2018 without language restrictions to explore the relationship between thyroid disorders and obesity. The relative risk (RR) or odds risk (OR) for thyroid disorders were pooled using the SPSS and STATA software.Results: A total of 22 studies were included in the study. (1) Meta-analysis showed that obesity was significantly associated with an increased risk of hypothyroidism (RR = 1.86, 95% CI 1.63–2.11, P < 0.001). Meta-analyses after stratification further showed that obese population had increased risks of overt hypothyroidism (RR = 3.21, 95% CI 2.12–4.86, P < 0.001) and subclinical hypothyroidism (RR = 1.70, 95% CI 1.42–2.03, P < 0.001). (2) Further meta-analysis also showed obesity was clearly associated with Hashimoto's thyroiditis (RR = 1.91, 95% CI 1.10–3.32, P = 0.022), but not with Graves' disease. (3) In the meta-analysis of antibodies, obesity was correlated with positive thyroid peroxidase antibody (TPOAb) (RR = 1.93, 95% CI 1.31–2.85, P = 0.001), but not with positive thyroglobulin antibody (TGAb).Conclusions: Obesity was significantly related to hypothyroidism, HT, and TPOAb, implying that prevention of obesity is crucial for thyroid disorders.Systematic Review Registration: PROSPERO: CRD42018096897.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

The Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis

et al. 2019

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“…Moreover, the contradiction may be more apparent than real. In some non-Western cultures characterized by different idioms of distress, and in which a certain stigma is attached to mental disorders depression may present to the physician as chronic or intractable musculoskeletal pain ( 102 ). Such a presentation is referred to as “masked depression” and could account for the apparent inverse relationship between the prevalence of depression and chronic low back pain in these countries ( 103 ).…”

Section: Discussionmentioning

confidence: 99%

The influence of cultural and religious factors on cross-national variations in the prevalence of chronic back and neck pain: an analysis of data from the global burden of disease 2019 study

Rajkumar

2023

Front. Pain Res.

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IntroductionLow back pain and neck pain are among the most commonly reported forms of chronic pain worldwide, and are associated with significant distress, disability and impairment in quality of life. Though these categories of pain can be analyzed and treated from a biomedical perspective, there is evidence that they are both related to psychological variables such as depression and anxiety. The experience of pain can be significantly influenced by cultural values. For example, cultural beliefs and attitudes can influence the meaning attached to the experience of pain, the responses of others to a sufferer's pain, and the likelihood of seeking medical care for particular symptoms. Likewise, religious beliefs and practices can influence the both experience of pain and the responses to it. These factors have also been associated with variations in the severity of depression and anxiety.MethodsIn the current study, data on the estimated national prevalence of both low back pain and neck pain, obtained from the 2019 Global Burden of Disease Study (GBD 2019), is analyzed in relation to cross-national variations in cultural values, as measured using Hofstede's model (n =115 countries) and in religious belief and practice, based on the most recent Pew Research Center survey (n = 105 countries). To address possible confounding factors, these analyses were adjusted for variables known to be associated with chronic low back or neck pain, namely smoking, alcohol use, obesity, anxiety, depression and insufficient physical activity.ResultsIt was found that the cultural dimensions of Power Distance and Collectivism were inversely correlated with the prevalence of chronic low back pain, and Uncertainty Avoidance was inversely correlated with the prevalence of chronic neck pain, even after adjustment for potential confounders. Measures of religious affiliation and practice were negatively correlated with the prevalence of both conditions, but these associations were not significant after adjusting for cultural values and confounders.DiscussionThese results highlight the existence of meaningful cross-cultural variations in the occurrence of common forms of chronic musculoskeletal pain. Psychological and social factors that could account for these variations are reviewed, along with their implications for the holistic management of patients with these disorders.

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Psychopharmacology of chronic pain

Ciaramella¹

2019

Psychopharmacology of Neurologic Disease

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Medically Unexplained Physical Symptoms with Masked Depression: A Case of Intractable Low Back Pain

Cited by 4 publications

References 8 publications

The Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis

The Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis

The influence of cultural and religious factors on cross-national variations in the prevalence of chronic back and neck pain: an analysis of data from the global burden of disease 2019 study

Psychopharmacology of chronic pain

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