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Year : 2022  |  Volume : 6  |  Issue : 1  |  Page : 38-43

Psychological correlates of disability among patients with chronic low back pain

1 Department of Psychiatry, BARC Hospital, Mumbai, Maharashtra, India
2 Department of Psychiatry, Medical Division, BARC Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Aditi P Chaudhari
Department of Psychiatry, BARC Hospital, Anushaktinagar, Mumbai - 400 088, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aip.aip_55_21

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Background: Chronic low back pain (cLBP) is pain that lasts for more than 3 months after the first acute episode of back pain. There is evidence that psychological factors are involved in the response to pain and hence the development of disability. There are very few Indian studies on the subject. This study was conducted to study the prevalence of psychiatric morbidity in patients with cLBP, to study the fear avoidance and pain catastrophizing in these patients, and to determine if these factors impact disability due to cLBP. Methodology: One hundred consecutive patients of cLBP, aged 18 to 60 years, with no previous psychiatric illness were assessed for depression, anxiety, and somatization using the Patient Health Questionnaire-9 (PHQ), Generalized Anxiety Disorder -7, and PHQ -15, respectively. Fear-avoidance beliefs and pain catastrophizing were assessed with the Fear Avoidance Beliefs Questionnaire and Pain Catastrophizing Scale, respectively. The Roland-Morris Disability Questionnaire was used to assess the disability. The data were pooled and statistically analyzed using Pearson's Correlation test and multiple regression analysis. Results: The prevalence of anxiety, depression, and somatization was 28%, 38%, and 34%, respectively. Fear-avoidance beliefs related to work and physical activity were high among 60% and 26%, respectively. Pain catastrophizing was high among 8% of patients. 32% patients had high disability. Disability correlated significantly with depression, somatization, and fear avoidance (work and physical activity) but following multiple regression analysis, fear-avoidance related to physical activity was the only predictor of disability. Conclusions: Disability assessment must be an integral part of the management of cLBP, and patients with high disability may be screened for psychiatric morbidity and fear-avoidance beliefs. The role of targeted interventions for these factors could then be explored.

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