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      Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta-Analysis.

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          Abstract

          To investigate the contribution of symptoms of depression to future episodes of low back pain (LBP).

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          Most cited references38

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          A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain.

          A systematic review of prospective cohort studies in low back pain. To evaluate the evidence implicating psychological factors in the development of chronicity in low back pain. The biopsychosocial model is gaining acceptance in low back pain, and has provided a basis for screening measurements, guidelines and interventions; however, to date, the unique contribution of psychological factors in the transition from an acute presentation to chronicity has not been rigorously assessed. A systematic literature search was followed by the application of three sets of criteria to each study: methodologic quality, quality of measurement of psychological factors, and quality of statistical analysis. Two reviewers blindly coded each study, followed by independent assessment by a statistician. Studies were divided into three environments: primary care settings, pain clinics, and workplace. Twenty-five publications (18 cohorts) included psychological factors at baseline. Six of these met acceptability criteria for methodology, psychological measurement, and statistical analysis. Increased risk of chronicity (persisting symptoms and/or disability) from psychological distress/depressive mood and, to a lesser extent, somatization emerged as the main findings. Acceptable evidence generally was not found for other psychological factors, although weak support emerged for the role of catastrophizing as a coping strategy. Psychological factors (notably distress, depressive mood, and somatization) are implicated in the transition to chronic low back pain. The development and testing of clinical interventions specifically targeting these factors is indicated. In view of the importance attributed to other psychological factors (particularly coping strategies and fear avoidance) there is a need to clarify their role in back-related disability through rigorous prospective studies.
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            A review of psychological risk factors in back and neck pain.

            S J Linton (2000)
            The literature on psychological factors in neck and back pain was systematically searched and reviewed. To summarize current knowledge concerning the role of psychological variables in the etiology and development of neck and back pain. Recent conceptions of spinal pain, especially chronic back pain, have highlighted the role of psychological factors. Numerous studies subsequently have examined the effects of various psychological factors in neck and back pain. There is a need to review this material to ascertain what conclusions may be drawn. Medical and psychological databases and cross-referencing were used to locate 913 potentially relevant articles. A table of 37 studies was constructed, consisting only of studies with prospective designs to ensure quality. Each study was reviewed for the population studied, the psychological predictor variables, and the outcome. The available literature indicated a clear link between psychological variables and neck and back pain. The prospective studies indicated that psychological variables were related to the onset of pain, and to acute, subacute, and chronic pain. Stress, distress, or anxiety as well as mood and emotions, cognitive functioning, and pain behavior all were found to be significant factors. Personality factors produced mixed results. Although the level of evidence was low, abuse also was found to be a potentially significant factor. Psychological factors play a significant role not only in chronic pain, but also in the etiology of acute pain, particularly in the transition to chronic problems. Specific types of psychological variables emerge and may be important in distinct developmental time frames, also implying that assessment and intervention need to reflect these variables. Still, psychological factors account for only a portion of the variance, thereby highlighting the multidimensional view. Because the methodologic quality of the studies varied considerably, future research should focus on improving quality and addressing new questions such as the mechanism, the developmental time factor, and the relevance that these risk factors have for intervention.
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              Use and misuse of population attributable fractions.

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                Author and article information

                Journal
                Arthritis Care Res (Hoboken)
                Arthritis care & research
                2151-4658
                2151-464X
                Nov 2015
                : 67
                : 11
                Affiliations
                [1 ] University of Sydney, Sydney, New South Wales, Australia.
                [2 ] The George Institute for Global Health and Institute of Bone and Joint Research, The Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.
                [3 ] Murcia Twin Registry, University of Murcia and IMIB-Arrixaca, Murcia, Spain.
                [4 ] The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
                [5 ] University of Sydney, Sydney, New South Wales, Australia & Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
                Article
                10.1002/acr.22619
                25989342
                07c4f51f-51e9-47dc-9be5-23c46030f8fe
                © 2015, American College of Rheumatology.
                History

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