Association of depression and chronic lower-back pain

Objectives: To study the prevalence of major depressive disorder, assess sleep quality, permanent functional disability as well as association of major depressive disorder with permanent disability, quality of life and quality of sleep in patients with chronic lower - back pain. Method: One hundred consecutive patients visiting an orthopaedic out patients department (OPD) with chronic lower - back pain in a tertiary hospital were included. They were interviewed for major depressive disorder (MDD) using DSM-5 and assessed for the severity of depression, health-related quality of life and sleep quality using the Hamilton Depression Rating Scale, Health Questionnaire Short Form (SF-36) and Pittsburgh Sleep Quality Index (PSQI), respectively. Proportion was compared using chi-square test, scores of scales were compared using the Mann -Whitney test and Kruskal-Wallis test followed by Dunn's post-hoc multiple comparisons. Statistical data were analyzed by Graph Pad InStat version 3.06. A p value of < 0.05 was considered statistically significant. Results: The frequency of major depressive disorder and poor quality of sleep in patients with chronic lower - back pain was 74 % and 81% respectively. Patients with MDD had poorer quality of sleep, lower quality of life and higher functional disability. Severe functional disability due to lower - back pain was associated with severe depressive symptoms poorer quality of sleep and lower quality of life. The severity of depression is positively correlated with functional disability. Patients with a pain lasting more than 1 year had greater chances of depression. Conclusions: Patients with chronic lower - back pain had a high frequency of depression poor quality of sleep and lower quality of life, and higher functional disability.