Dataset Information

Depression and anxiety as major determinants of neck pain: a cross-sectional study in general practice.

ABSTRACT:

Background

Although psychosocial factors are known to be highly linked with neck pain, current therapies focus on somatically based interventions such as medicinal or manipulatory therapies. This study examines how socio-demographic, psychosocial and medical history and health-promoting lifestyle factors interact with neck pain in general practice patients.

Methods

This is a cross-sectional survey including 448 patients from a general practice setting in Germany. Participants completed a comprehensive questionnaire including the Neck Pain and Disability Scale German version (NPAD-d) and the Hospital Anxiety and Depression Scale. Crude and adjusted regression analyses were done to assess the relationship between neck pain and socio-demographic, psychosocial and medical history and health-promoting lifestyle factors.

Results

Both in crude and adjusted regression analyses, depression and anxiety were highly significantly linked with increasing levels of neck pain. Educational level, deficits in social support and physical exercise were associated with neck pain in bivariate analyses, but these associations did not persist with adjustment for depression and anxiety. When investigating levels of depression and anxiety by NPAD-d quartile subgroups, those who were identified to have depressive mood or to be anxious were very likely to be in the group with the highest levels of neck pain.

Conclusion

The higher the neck pain level, the more attention should be paid to psychosocial distress as a related burden. Further research is needed to elucidate the causality and the direction of the association between psychosocial distress and neck pain and to determine the benefit of psychosocial interventions.

SUBMITTER: Blozik E

PROVIDER: S-EPMC2636754 | biostudies-literature | 2009 Jan

REPOSITORIES: biostudies-literature

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Publications

Depression and anxiety as major determinants of neck pain: a cross-sectional study in general practice.

Blozik Eva E Laptinskaya Daria D Herrmann-Lingen Christoph C Schaefer Helene H Kochen Michael M MM Himmel Wolfgang W Scherer Martin M

BMC musculoskeletal disorders 20090126

<h4>Background</h4>Although psychosocial factors are known to be highly linked with neck pain, current therapies focus on somatically based interventions such as medicinal or manipulatory therapies. This study examines how socio-demographic, psychosocial and medical history and health-promoting lifestyle factors interact with neck pain in general practice patients.<h4>Methods</h4>This is a cross-sectional survey including 448 patients from a general practice setting in Germany. Participants comp ...[more]

PMID: 19171034

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Project description:BackgroundIn developed countries, primary care physicians manage most patients with depression. Relatively few studies allow a comprehensive assessment of the decisions these doctors make in these cases and the factors associated with these decisions. We studied how general practitioners (GPs) manage the acute phase of a new episode of non-comorbid major depression (MD) and the factors associated with their decisions.Methodology/principal findingsIn this cross-sectional telephone survey, professional investigators interviewed an existing panel of randomly selected GPs (1249/1431, response rate: 87.3%). We used case-vignettes about new MD episodes in 8 versions differing by patient gender and socioeconomic status (blue/white collar) and disease intensity (mild/severe). GPs were randomized to receive one of these 8 versions. Overall, 82.6% chose pharmacotherapy; among them GPs chose either an antidepressant (79.8%) or an anxiolytic/hypnotic alone (18.5%). They rarely recommended referral for psychotherapy alone, regardless of severity, but 38.2% chose it in combination with pharmacotherapy. Antidepressant prescription was associated with severity of depression (OR?=?1.74; 95%CI?=?1.33-2.27), patient gender (female, OR?=?0.75; 95%CI?=?0.58-0.98), GP personal characteristics (e.g. history of antidepressant treatment: OR?=?2.31; 95%CI?=?1.41-3.81) and GP belief that antidepressants are overprescribed in France (OR?=?0.63; 95%CI?=?0.48-0.82). The combination of antidepressants and psychotherapy was associated with severity of depression (OR?=?1.82; 95%CI?=?1.31-2.52), patient's white-collar status (OR?=?1.58; 95%CI?=?1.14-2.18), and GPs' dissatisfaction with cooperation with mental health specialists (OR?=?0.63; 95%CI?=?0.45-0.89). These choices were not associated with either GPs' professional characteristics or psychiatrist density in the GP's practice areas.Conclusions/significanceGPs' choices for treating severe MD complied with clinical guidelines better than those for mild MD; GPs rarely recommended psychotherapy alone but rather as a complement to pharmacotherapy. Their decisions were mainly influenced by personal life experience and attitudes regarding treatment more than by professional characteristics. These results call into question the methods and content of continuing medical education in France about MD management.

Project description:BACKGROUND: Antidepressant prescribing continues to rise. Increased long-term prescribing and higher doses are contributing to current growth; however, patient factors associated with the use of higher doses remain unknown. This study's aim was to investigate patient factors associated with selective serotonin re-uptake inhibitor (SSRI) prescribed daily dose for depression treatment in general practice. METHODS: A stratified sample of low to high prescribing practices were selected. Routine individual patient-level data were extracted one practice at a time: September 2009 to January 2011. Patients included were ?18 years, and prescribed an SSRI for depression. Logistic regression analysis was undertaken to assess individual predictor variables on SSRI daily dose by standard therapeutic dose versus higher dose, as SSRIs demonstrate flat dose response curves for depression treatment. Predictor variables included: age, gender, deprivation, co-morbidity, smoking status, being prescribed the same SSRI for ?2 years, and patients' general practice. For a subgroup of patients a second sub-group analysis included long-term benzodiazepine and/or z-hypnotic (B&Z) as a predictor variable. RESULTS: Inter-practice SSRI prescribing varied significantly; practice point prevalence ranged from 2.5% (94/3697) to 11.9% (359/3007) of the practice population ?18 years old; median 7.3% (250/3421) (?2 = 2277.2, df = 10, p < 0.001). Overall point prevalence was 6.3% (3518/52575), with 5.8% (3066/52575) prescribed SSRIs for depression of whom 84.7% (2596/3066) had data for regression analysis. Higher SSRI doses were significantly associated with, in descending order of magnitude, individual practice attended, being prescribed the same SSRI for ?2 years (Odds Ratio (OR) 1.80, 95% CI 1.49 to 2.17, p < 0.001) and living in a more deprived area (OR 1.55, 95% CI 1.11 to 2.16, p = 0.009). Higher SSRI doses in the B&Z subgroup were significantly associated with individual practice attended, being prescribed a long-term B&Z (OR 2.05 95% CI 1.47 to 2.86, p < 0.001) and being prescribed the same SSRI for ?2 years (OR 1.94, 95% CI 1.53 to 2.47, p < 0.001). CONCLUSION: Higher SSRI doses for depression were associated with practice attended and being prescribed the same antidepressant for ?2 years. As long-term antidepressant use increases, the use of higher doses may further contribute to prescribing growth.

Project description:BackgroundAn increase in the demand for general practitioners is expected in many countries, but only a minority of medical students consider a career in general practice. More detailed and up-to-date knowledge about medical student's perception of general practice would be helpful for efforts to encourage medical students to consider a career in general practice.MethodsWe performed a cross-sectional single center survey among Dutch medical students to evaluate their perception of general practice at three different stages in their study: Ba1: first-year bachelor students; Ba3: third-year bachelor students; Ma3: third-year master students. The impact of different factors on their attitudes and perceptions was quantified. A multivariate logistic regression was performed with 'interest in general practice' as the outcome variable.ResultsThe median age for Ba1 was 18 (IQR: 18-19) and 71.5% were female, for Ba3 the median age was 20 (IQR: 20-21) and 70.6% were female and for Ma3 the median age was 25 years (IQR: 24-26) and 73.3% were female. On average, 31.2% of the respondents had a migration background. The mean response rate for this study was 77.1%. Of the participating Ba1 students (n = 340) only 22.4% considered working as a GP after medical school; for Ba3 students (n = 231) this percentage was 33.8%, and for Ma3 students (n = 210) it was significantly higher at 70.5%; in the final multivariate model this corresponded to an odds ratio (OR) of 4.3 (95%-CI:2.6-6.9) compared to Ba1 students. The strongest predictor in the final model was the opinion that general practice provides a pleasant working environment (OR 9.5; 95%-CI: 6.2-14.5).ConclusionThis study showed that multiple factors are significantly related to medical students' interest in general practice. Although students believed that general practice does not have a high status within the medical profession, they acknowledged the social importance and the pleasant working environment of general practice. Knowledge obtained in this study can be used when designing a medical curriculum or a general practice course.

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Project description:ObjectivesThe study aims to assess prevalence of smartphone addiction symptoms, and to ascertain whether depression or anxiety, independently, contributes to smartphone addiction level among a sample of Lebanese university students, while adjusting simultaneously for important sociodemographic, academic, lifestyle, personality trait, and smartphone-related variables.MethodsA random sample of 688 undergraduate university students (mean age = 20.64 ±1.88 years; 53% men) completed a survey composed of a) questions about socio-demographics, academics, lifestyle behaviors, personality type, and smartphone use-related variables; b) 26-item Smartphone Addiction Inventory (SPAI) Scale; and c) brief screeners of depression and anxiety (PHQ-2 and GAD-2), which constitute the two core DSM-IV items for major depressive disorder and generalized anxiety disorder, respectively.ResultsPrevalence rates of smartphone-related compulsive behavior, functional impairment, tolerance and withdrawal symptoms were substantial. 35.9% felt tired during daytime due to late-night smartphone use, 38.1% acknowledged decreased sleep quality, and 35.8% slept less than four hours due to smartphone use more than once. Whereas gender, residence, work hours per week, faculty, academic performance (GPA), lifestyle habits (smoking and alcohol drinking), and religious practice did not associate with smartphone addiction score; personality type A, class (year 2 vs. year 3), younger age at first smartphone use, excessive use during a weekday, using it for entertainment and not using it to call family members, and having depression or anxiety, showed statistically significant associations with smartphone addiction. Depression and anxiety scores emerged as independent positive predictors of smartphone addiction, after adjustment for confounders.ConclusionSeveral independent positive predictors of smartphone addiction emerged including depression and anxiety. It could be that young adults with personality type A experiencing high stress level and low mood may lack positive stress coping mechanisms and mood management techniques and are thus highly susceptible to smartphone addiction.

Dataset Information

Depression and anxiety as major determinants of neck pain: a cross-sectional study in general practice.

Background

Methods

Results

Conclusion

Publications

Depression and anxiety as major determinants of neck pain: a cross-sectional study in general practice.

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