Study design: A cross-sectional study.
Objective: This study was designed to analyze the relationship between the presence and severity of depression and low back pain (LBP) in a representative sample of the general population using a self-report screening questionnaire for depression.
Summary of background data: There is increasing evidence supporting an association between depression and LBP. However, the degree of the association between these two conditions in the general population is poorly understood.
Methods: Health surveys and examinations were conducted on a nationally representative sample (n = 7550) of Koreans. LBP status was determined by a simple survey response concerning LBP >30 days during the past 3 months. Depression was defined as individuals with a total score >10 on the Patient Health Questionnaire (PHQ)-9 survey. The severity of depression was categorized as none (0-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe (20-27) according to PHQ-9 score. Data regarding demographics, socioeconomic history, and comorbid health conditions were used to analyze adjusted, weighted logistic regression models.
Results: In the Korean population, the prevalence of depression was significantly greater in individuals with LBP (20.3%) than in those without LBP (4.5%). On multivariate logistic regression analysis, the presence of depression was significantly associated with LBP (adjusted odd ratio [aOR]: 3.93, P < 0.001). The risk of LBP increased with increasing severity of depression as follows: severe depression (aOR: 9.28, P < 0.001), moderately severe depression (aOR: 3.24, P = 0.001), moderate depression (aOR: 4.97, P < 0.001), and mild depression (aOR: 2.48, P < 0.001).
Conclusion: Depression is more common in patients with LBP among Koreans. The presence of depression was significantly associated with LBP, especially in severely depressed individuals.
Level of evidence: 3.