The Impact of Anxiety and Depression on the Outcomes of Chronic Low Back Pain Multidisciplinary Pain Management—A Multicenter Prospective Cohort Study in Pain Clinics with One-Year Follow-up

Abstract

Anxiety, depression, and their interaction are associated with changes in pain disability at one-year follow-up. These findings encourage the pretreatment screening of anxiety and depression as independent symptoms in patients with CLBP in order to design more tailored and effective multidisciplinary treatments.

Pain Intensity as a Lagging Indicator of Patient Improvement: Longitudinal Relationships With Sleep, Psychiatric Distress, and Function in Multidisciplinary Care

“…The lagged effect of disability on pain intensity is notable as it supports a rehabilitative approach to chronic pain that emphasizes restoring meaningful function as a potential path to meaningful pain reduction. Similarly, our findings are in accordance with prior research indicating univariate longitudinal relationships between pain intensity and depressive and anxious symptoms 38,44 and sleep disturbance, 41 but extend this finding by estimating the independent predictive value of these variables on later pain intensity. Notably, however, neither depressive symptoms nor anxious symptoms were significantly associated with later pain intensity, above and beyond the effects of Figure 5.…”

“…Existing research implicates psychiatric distress as a potential barrier toward effective pain rehabilitation. Symptoms of depression and anxiety are strong correlates of chronic pain in cross-sectional studies, 33,49 and appear to be predictive factors for long-term changes in pain intensity 21,38,44 and functional impairment. 1,21,32,39 Similarly, symptoms of post-traumatic stress disorder (PTSD) may play a role in both a greater likelihood of chronic pain after traumatic injury 22,47 and in prolonging or worsening the intensity of pain in chronic pain treatment settings.…”

Diagnosis, pathophysiology, management and future issues of trigeminal surgical nerve injuries

“…The presence of anxiety or depression has been suggested to negatively affect treatment outcomes in other pain conditions. 46 In striving for better outcomes, it is therefore advisable to also pay attention to the psychological impact. Psychological assessment requires the use of validated questionnaires exploring anxiety, depression, post-traumatic stress disorder, catastrophising and somatisation.…”

The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review

“…Findings of these two reviews are therefore limited in generalizability to these LBP subgroups. Moreover, many primary studies have been published in this area since 2014 [37][38][39][40][41][42][43][44][45][46][47], particularly around disability, medication use, and surgical outcomes. A comprehensive and up-todate systematic review is needed to inform future research and practice, and improve health services delivery and quality of care for LBP.…”