Abstract
Background Individuals with chronic pain have been reported to have an increased incidence of
psychological morbidities. We aimed to examine the prevalence of anxiety, depression,
disability, alexithymia, insomnia, and sleep quality in patients having chronic low
back pain (LBP) and study their association with the severity of pain and any disability
arising from it.
Methods This descriptive study was conducted in a tertiary care teaching hospital setting.
Fifty adults with nonspecific LBP of > 6-week duration were included. Study instruments
employed were patient health questionnaire-9 for depression, generalized anxiety disorder-7
for anxiety, visual analogue scale (VAS) score for pain, Oswestry disability index
(ODI) to assess disability, Toronto alexithymia scale-20 for alexithymia, and insomnia
severity index and Pittsburgh sleep quality index for insomnia. Descriptive results
were expressed as numbers, means, and proportions. Association study between variables
was performed using Fisher’s exact test.
Results Mean ODI score was 31.54% (95% CI, 26.09–36.99); mean VAS score was 6.08 (95% CI,
5.35–6.81). Insomnia of varying severity was found in 29 patients. Sleep quality was
reported as good by 23 patients. One patient had alexithymia. There was significant
association between the level of disability and depression, anxiety, insomnia, and
sleep quality. The severity of pain had significant association with insomnia but
the association with anxiety, depression, alexithymia, and sleep quality was not significant.
Conclusions Patients with chronic LBP do have associated psychological comorbidities of varying
extent. A “patient-centric” approach when treating patients with chronic LBP is necessary,
so that appropriate evaluation of psychiatric and psychosocial comorbidities, sleep
problems, and quality of life is done as part of their routine management to ensure
the desired outcomes.
Keywords
low back pain - psychological - comorbidity - anxiety - depression - alexithymia -
insomnia
