Clinical Influence of Emotional Depression on Chronic Low Back Pain.

, Seok, Hyun; , Son, Bong Ki; , Ha, Young Ran; , Ryu, Ho Hyun; , Moon, Jae Ho

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2003;27(4):568-574.

Seok, Hyun , Son, Bong Ki , Ha, Young Ran , Ryu, Ho Hyun , Moon, Jae Ho

¹Department of Rehabilitation Medicine, Soonchunhyang University College of Medicine, Korea. seok50503@daum.net
²Department of Psychiatry, Hallym University Colleg of Medicine, Korea.
³Department of Rehabilitation Medicine, Yonsei University College of Medicine, Korea.
⁴Department of Rehabilitation Psychology, Yongdong Severance Hospital, Korea.

Abstract

OBJECTIVE
To compare the patients of chronic low back pain with and without emotional depression in terms of psychosomatic aspect and clinical outcome by cross-sectional and prospective study. METHOD: We evaluated 100 patients who were admitted due to chronic low back pain. The patients were classified into three groups (moderately depressed, mild depressed, non-depressed) by the score of Beck Depression Inventory (BDI). And three groups were compared by Pain Disability Index (PDI), Visual Analogue Scale (VAS), Pain Rating Score (PRS) and special diagnostic studies such as MRI and EMG. All subjects took the same conservative treatments for 4 weeks and then, they were re-evaluated by PDI, VAS and PRS.
RESULTS
BDI score was positively correlated with VAS and PRS significantly. All groups were not different with respect to functional limitation (measured by PDI) and organic lesion (measured by MRI and EMG study). But, subjective pain (measured by VAS, PRS) were severe in depressed group. All groups showed improvement in PDI, VAS and PRS after 4 weeks of treatment. But, the amount of improvement was greater in non-depressed group.
CONCLUSION
The clinician treating chronic low back pain should be familiar with depression and prepare for screening on that.

Key Words: Chronic low back pain, Depression, Beck Depression Inventory (BDI)