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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two studies designed to examine the self-report of depressive symptoms in low back pain patients are presented. Symptoms of depression were assessed with the Beck Depression Inventory. In the first study, a sample (N = 134) of patients who presented for neurosurgical evaluation were evaluated. In the second study, a subgroup of patients found to have lumbar disc protrusion were compared to a subgroup with few or no positive physical findings at the time of physical examination. If the cut-off scores recommended by Beck were used, patients in both studies would be classified as mildly depressed. Both studies found that patients were significantly more likely to report somatic than cognitive symptoms of depression. Patients with multiple physical findings or a disc abnormality at the time of operation were not found to be more likely to report somatic symptoms than patients with few physical findings.
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PMID:Self-report of depressive symptoms in low back pain patients. 294 Feb 66

Patients with chronic pain syndromes are commonly depressed. Chronic pain populations also contain distinct subgroups of personality profiles as defined by the MMPI. To assess the relevance of personality subtype to affective disorder we determined the relationship of psychiatric diagnoses defined by Research Diagnostic Criteria (RDC) to MMPI subgroups in a sample of hospitalized patients with predominantly chronic low back pain. RDC psychiatric diagnoses for the sample were major depression (44.2%), minor depression (19.2%), other psychiatric disorder (13.5%), and no mental disorder (21.6%). Patients satisfying RDC criteria for major depression were significantly associated with discrete MMPI personality subtypes. No other psychiatric diagnoses were significantly associated with distinct personality subgroups. No relationship was observed between personality profile and presence of demonstrable organic etiology for pain. These findings indicate that behavioral and pharmacological interventions directed at depression as well as pain are important in the treatment of chronic pain populations, especially in selected subgroups.
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PMID:MMPI subgroups and affective disorder in chronic pain patients. 294 21

An association between chronic pain and depression has been recognised for a long time. However, the exact nature of this association remains unclear. The authors studied 80 consecutive patients with chronic low back pain. Different types of depression were diagnosed using Research Diagnostic Criteria. The relationship between different types of depression and clinical and demographic variables are presented. Beck Depression Inventory and the Montgomery-Asberg Depression Rating Scale were used in an attempt to discriminate between the different types of depression.
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PMID:Depression as a psychopathological disorder in chronic low back pain patients. 294 66

In an attempt to clarify the relationship between chronic pain and depression, the authors studied the plasma cortisol response to dexamethasone in a group of 73 consecutive chronic low back pain patients admitted to a pain unit and 34 consecutive patients admitted to an affective disorders unit with the principal diagnosis of primary major depression. Patients with chronic pain were evaluated as to the presence or absence of major depression and patients with primary major depression were evaluated as to the presence or absence of pain complaints as part of their presenting symptomatology. Chronic pain patients with major depression differed significantly from chronic pain patients without major depression (3.4 +/- 3.33 micrograms/dl versus 1.6 +/- 0.9 micrograms/dl, P less than 0.05). Chronic pain patients with major depression also differed from patients with primary major depression with pain complaints (3.4 +/- 3.3 micrograms/dl versus 10.7 +/- 8 micrograms/dl, P less than 0.0005). The values given are post-dexamethasone plasma cortisol levels. Patients having primary major depression with pain complaints do not significantly differ from patients having primary major depression without pain complaints. The dexamethasone suppression test may be a useful method in discriminating those patients with chronic pain versus those with primary major depression, chronic pain patients with major depression versus those with primary major depression and chronic pain patients with major depression versus those with chronic pain and no depression.
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PMID:Chronic pain and depression. IV. DST as a discriminator between chronic pain and depression. 295 Mar 65

Three self-report questionnaires (the Beck Depression Inventory, the MMPI-D scale, and the depression subscale of the Middlesex Hospital Questionnaire) were examined to see how accurately they could identify chronic low back pain patients who were suffering depression, as defined by DSM-III criteria. According to these criteria, 25% of a sample of 68 patients currently were depressed, a rate comparable to those reported by other studies that have used standardized criteria. On the basis of relative conditional probability ratios, the BDI was shown to be the most efficient instrument for identifying these cases and represents an excellent screening device for depression with this population. The individual items of the BDI then were examined, and the conditional probability ratios revealed that several may be helpful as indicators of possible depression among chronic low back pain patients. The relationship between depression and chronic pain is reconsidered in the light of these results.
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PMID:Depression in chronic low back pain patients: diagnostic efficiency of three self-report questionnaires. 295 98

The relationship between depression and chronic low back pain (LBP) is controversial. Theorists differ in the emphasis they place on predisposing versus reactive factors in LBP disability and depression. Alexithymia has been suggested as a predisposing factor in psychosomatic disorders, including chronic LBP. This study addresses the association between depression, alexithymia, and LBP using the Rorschach comprehensive system. LBP patients were hypothesized to be distinguishable from Research Diagnostic Criteria-diagnosed inpatient depressives, to exhibit features of alexithymia, and to resemble a group of DSM-III personality disorders. Subjects were 33 chronic LBP patients. Results supported the hypotheses. On depression measures, LBP patients differed significantly from depressives (p less than .001). LBP patients exhibited Rorschach features consistent with alexithymia. They also exhibited a number of similarities to the personality disorders group. The role of alexithymia as a cognitive-mediating factor in coping and adaptation is discussed.
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PMID:Depression, alexithymia, and pain prone disorder: a Rorschach study. 295 16

The purpose of the present study was to determine whether patients with recurrent low back pain display a different pattern of mood fluctuations across days than matched healthy controls and whether these mood states are related to pain occurrence and/or magnitude using a prospective design. The questions addressed are whether mood states prior to a pain episode are associated with the episode or whether mood relates to pain as a secondary reaction. Similarly, the relationship between mood state recorded prior to, during or following pain and magnitude of pain experienced was investigated. Thirty-three ambulatory chronic low back pain patients and an equivalent group of asymptomatic controls matched for age, sex, socioeconomic status, and reported activity level monitored mood state (anxiety, tension, depression, anger, vigor, fatigue, confusion) and pain before breakfast, at 4 p.m. and at bedtime for 14 consecutive days. Groups were successfully matched. Analyses revealed significantly higher levels of tension, anxiety and fatigue and lower levels of vigor in the pain cases. No mood state was predictive of pain onset but fatigue was associated with pain 24 h following pain, indicating fatigue as secondary to pain. While mood state recorded prior to or following pain was unable to predict magnitude of pain, fatigue was associated with the level of pain experienced during the pain episode itself. The findings reveal a pattern of anxiety, tension and fatigue where fatigue is associated with increased pain during the pain episode and is increased 24 h following pain. This fatigue-pain relationship is superimposed upon a continuous elevation of anxiety and tension. These findings suggest the importance of pain management efforts directed at decreasing patients' fatigue levels, and increasing functional endurance while simultaneously reducing anxiety. The results also question the role of negative mood states in the initiation or exacerbation of pain and highlights the influence of physical mood states such as fatigue on pain in low back pain.
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PMID:A prospective analysis of stress and fatigue in recurrent low back pain. 296 55

Chronic low back pain (CLBP) patients with pain and symptomatology incongruent with physical pathology have been found to have a poorer outcome to medical treatment and rehabilitation, and to use health care resources excessively. To examine possible psychological and behavioral bases for this pattern, this investigation contrasted 40 CLBP patients who displayed non-organic physical signs, inappropriate symptoms, and/or anatomically incongruent pain drawings with 40 'control' CLBP patients without incongruent pain criteria. Multivariate analyses revealed that the incongruent CLBP group reported greater pain intensity and depression, received higher observer ratings of pain, displayed more ambulatory/postural pain behavior, and reported more dysfunctional cognitions during pain. Incongruent CLBP patients also were found to have greater physical impairment and disability. When group differences on physical impairment/disability were controlled statistically, all the afore-mentioned differences disappeared, with one exception. Incongruent CLBP patients still displayed more maladaptive and dysfunctional cognitions. These findings indicate that incongruent CLBP patients may be conceptualized as ineffective and overwhelmed in their attempts to cope and as more physically disabled as a result of their pain. The role of cognitive factors, reasons for failure of physically based interventions, and implications for patient management are discussed.
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PMID:Medically incongruent chronic back pain: physical limitations, suffering, and ineffective coping. 296 50

This article evaluates the role of aerobic exercise in the treatment of low back pain and related disability. A regular exercise program can improve strength and endurance, prevent fatigue from causing improper body mechanics, increase beta-endorphin levels, reduce depression and give patients an overall feeling of well-being.
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PMID:Aerobic exercise in the treatment and prevention of low back pain. 296 86

This study used the Attributional Style Questionnaire to study the attributional styles of depressed and nondepressed chronic low back pain patients (N = 91) in order to test the Revised Learned Helplessness model's prediction of differences between the two. The results partly supported the hypothesis; an internal, stable, global style for negative events distinguished the depressed group from the nondepressed, but there were no differences in attributional style for positive events. The findings are consistent with recent reviews of the literature that have reported general support for the negative outcome style, but consistent failure to confirm the predictions associated with positive outcome style. In addition, the attributional style was not common to all subjects in the depressed group, which suggested that other factors may be involved in the development of different subtypes of depression. Implications for studying attributional aspects of depression and chronic low back pain are discussed.
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PMID:Attributional style of depressed chronic low back patients. 296 70


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