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ORIJINAL ARAŞTIRMA

Kronik Bel veya Boyun Ağrılı Hastalarda Anksiyete ve Depresyonun Ağrı Şiddeti ve Ağrı ile İlişkili Disabiliteye Etkisinin İncelenmesi
Investigation of the Effect of Anxiety and Depression on Pain Severity and Pain-Related Disability in Patients with Chronic Low Back or Neck Pain
Received Date : 26 Jun 2021
Accepted Date : 06 Dec 2021
Available Online : 10 Dec 2021
Doi: 10.31609/jpmrs.2021-85185 - Makale Dili: TR
J PMR Sci. 2022;25(2):166-72
ÖZET
Amaç: Bu çalışmanın amacı, bel veya boyun ağrısını etiyolojisinde, seyrinde ve tedaviye yanıtta etkili olduğu düşünülen anksiyete ve depresyon gibi psikiyatrik semptomların kronik ağrı şiddeti ve ağrı ile ilişkili disabiliteye ne ölçüde etki ettiğinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Kesitsel klinik araştırma olarak planlanmış bu çalışmaya toplam 235 katılımcı dâhil edilmiştir (75 katılımcı bel ağrısı grubuna, 75 katılımcı boyun ağrısı grubuna, 85 katılımcı sağlıklı kontrol grubuna). Üç gruptaki hastaların Hastane anksiyete depresyon ölçeği (HAD) skorları karşılaştırıldı. Bel ve boyun ağrısı grubunda HAD-Anksiyete ve HAD-Depresyon skorları ile vizüel analog skala, Quebec Bel Ağrısı Disabilite Ölçeği ve Boyun Disabilite Ölçeği arasındaki ilişki incelendi. Bulgular: Bel ağrısı ve boyun ağrısı grubunda kontrol grubuna göre HAD-Anksiyete alt ölçeği skorları anlamlı olarak yüksek saptandı (p<0,05). HAD-Depresyon alt ölçeği skorlarında bel ağrısı ve boyun ağrısı olan hastalarla kontrol grubu arasında anlamlı fark saptanmadı (p>0,05). Çok değişkenli regresyon analizi sonuçlarına göre bel ağrısı grubunda cinsiyet ve anksiyete disabilite üzerine etkili faktörler olarak saptandı [sırasıyla ß=-7,223 (-16,95/-1,92), p=0,046; ß=1,724 (0,73/2,78), p=0,001]. Ağrı üzerine ise yalnızca anksiyetenin etkili olduğu tespit edildi [ß=1,798 (0,69/2,91), p=0,002]. Boyun ağrısı grubunda ise depresyon disabilite üzerine etkili bir faktör olarak saptandı [ß=0,981 (0,47/1,49), p<0,001]. Sonuç: Kronik bel ya da boyun ağrılı hastalarda anksiyete ve depresyon ağrı şiddetini ve disabilite üzerine orta derecede etkili faktörlerdir. Kronik boyun veya bel ağrılı hastalar anksiyete ve depresyon riski açısından değerlendirilmelidir. Anksiyete ya da depresyon riski saptanan hastalarda bel ya da boyun ağrısı için uygulanan tedavilerin yanı sıra; anksiyete ve depresyona yönelik medikal ya da bilişsel davranışsal tedavi gibi yöntemlerden yararlanılması tedavi sonuçlarımızı iyileştirebilir ve hastaların fonksiyonelliklerini artırabilir.
ABSTRACT
Objective: The aim of this study was to examine to what extent psychiatric symptoms such as anxiety and depression, which are thought to be effective in the etiology, course and response to treatment of low back or neck pain, affect chronic pain severity and pain-related disability. Material and Methods: A total of 235 participants were included in this study, which was planned as a cross-sectional clinical study (75 participants in the low back pain group, 75 participants in the neck pain group, 85 participants in the healthy control group). The Hospital anxiety and depression scale (HAD) scores of the participants in the 3 groups were compared. In the low back and neck pain group, the relationship between HAD-Anxiety and HAD-Depression scores and visual analog scale, Quebec Low Back Pain Disability Scale and Neck Disability Scale was examined. Results: HAD-Anxiety subscale scores were found to be significantly higher in the low back and neck pain group compared to the control group (p<0.05). There was no significant difference in HAD-Depression subscale scores between the patients with low back and neck pain and the control group (p>0.05). According to the results of multivariate regression analysis, gender and anxiety were found to be effective on disability in the low back pain group [ß=-7.223 (-16.95/-1.92), p=0.046; ß=1.724 (0.73/2.78), p=0.001, respectively]. It was determined that only anxiety was effective on pain [ß=1.798 (0.69/2.91), p=0.002]. In the neck pain group, depression was found to be effective on disability [ß=0.981 (0.47/1.49), p<0.001]. Conclusion: Anxiety and depression are moderate effective factors on pain severity and disability in patients with chronic low back or neck pain. Patients with chronic neck or low back pain should be evaluated for the risk of anxiety and depression. In addition to the treatments applied for low back or neck pain in patients with anxiety or depression risk using methods such as medical or cognitive behavioral therapy for anxiety and depression can improve our treatment results and increase the functionality of patients.
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