Ümit DÜNDAR, Özlem SOLAK, Ümit Seçil DEMİRDAL, Hasan TOKTAŞ, Vural KAVUNCU

Kronik bel ağrılı hastalarda ağrı, yeti yitimi ve depresyonun yaşam kalitesi ile ilişkisi

Amaç: Bu çalışmanın amacı kronik bel ağrılı hastalarda depresyon, ağrı ve yeti yitimi seviyesini araştırmak ve yaşam kalitesi ile ilişkisini belirlemektir. Yöntem: 41 kronik bel ağrılı hasta ve yaş ve cinsiyet açısından benzer 42 sağlıklı kontrol çalışmaya dahil edildi. Hastalar ve kontroller görsel anolog skala (GAS) ile istirahat ve hareket ağrısı açısından değerlendirildi. Aktif hareket açıklığı inklinometre ve gonyometre ile ölçüldü. Yeti yitimi ve yaşam kalitesi ise modifiye Oswestry bel yeti yitimi anketi (MOBDA) ve kısa form-36 (SF-36) ile değerlendirildi. Ayrıca tüm hastalara ve kontrollere Beck Depresyon ölçeği (BDÖ) uygulandı. Bulgular: Olgular ve kontroller arasında demografik veriler açısından fark yoktu. Hastaların SF-36 skorları kontrollerden daha düşüktü. Kronik bel ağrılı hastalarda MOBDA, BDÖ ve GAS skorları kontrollere göre yüksekti. Kronik bel ağrılı hastaların BDÖ skorları ile SF-36’nın alt parametreleri arasında negatif ve yakın bir ilişki bulundu (fiziksel işlevler (r:-0,46, p

PDF

___

1. Bonica-Loeser JD. Low back pain. In: Loeser JD, (ed.): Bonica’s management of pain. Philadelphia: Lippincott Williams & Wilkins; 2001:1508-64.
2. Loney PL, Stratford PW. The prevalence of low back pain in adults; A methodological review of the literature. Phys Ther 1999;4:384-95.
3. Andersson G. Epidemiologic aspects on low back pain in industry. Spine 1981;6:53-60.
4. Liddle SD, Baxter GD, Gracey JH. Exercise and chronic low back pain: What works? Pain 2004;107:176-90.
5. Kokino S, Özdemir F, Tuna H. Kronik bel ağrısı olgularına uygulanan biofeedback, egzersiz, biofeedback+egzersiz tedavilerinin Beck Depresyon Skalasına etkisi. Ağrı 1999;11:141.
6. Doksat MK. Ağrı ve psikiyatri. Ege Psikiyatri Sürekli Yayınları: Konsültasyon Liyezon Psikiyatrisi-II, 1997;2:189-203.
7. Özcan ME, Yurtsızoğlu Ö, Balki S, Altay Z, Eğri M. Bel ağrısı olan hastalarda hot-pack, TENS, ultrasound ve egzersizin HAMD skorlarına etkisi. Anadolu Psikiyatri Derg 2000;1:26-31.
8. Frank AO, Souza LD. Conservative management of lowback pain. Int J Clin Pract 2001;55:21–31
9. Hanley MA, Jensen MP, Ehde DM, Hoffman AJ, Patterson DR, Robinson LR. Psychosocial predictors of long-term adjustment to lower-limb amputation and phantom limb pain. Disabil Rehabil 2004;26:882-93.
10. Jensen MP, Ehde DM, Hoffman AJ, Patterson DR, Czerniecki JM, Robinson LR. Cognitions, coping and social env predict adjustment to phantom limb pain. Pain 2002;95:133-42.
11. Turk DC, Okifuji A. Psychological factors in chronic pain: Evolut and revolut. J Consult Clin Psychol 2002;70: 678-90.
12. Sullivan MJ, Adams H, Thibault P, Corbiere M, Stanish WD. Initial depression severity and the trajectory of recovery following cognitive-behavioural intervention for work disability. J Occup Rehabil 2006;16:63-74.
13. Sullivan MJ, Feuerstein M, Gatchel R, Linton SJ, Pransky G. Integrating psychosocial and behavioral interventions to achieve optimal rehabilitation outcomes. J Occup Rehabil 2005;15:475–89.
14. Smith BH, Elliott AM, Hannaford PC, Chambers WA, Smith WC. Factors related to the onset and persistence of chronic back pain in the community: Results from a general population follow-up study. Spine 2004;29:1032–40.
15. Boersma K, Linton SJ. Psychological processes underlying the development of a chronic pain problem: A prospective study of the relationship between profiles of psychological variables in the fear-avoidance model and disability. Clin J Pain 2006;22:160–6.
16. Linton SJ. A review of psychological risk factors in back and neck pain. Spine 2000;25:1148–56.
17. Clauw DJ, Williams D, Lauerman W, Dahlman M, Aslami A, Nachemson AL, et al. Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain. Spine 1999;24:2036–41.
18. Epping-Jordan JE, Wallgren DR, Williams RA, Pruitt SD, Slater MA, Patterson TL, et al. Transition to chronic pain in men with low back pain: Predictive relationships among pain intensity, disability, and depressive symptoms. Health Psychol 1998;17:421–7.
19. Kessler M, Kronstorfer R, Traue HC. Depressive symptoms and disability in acute and chronic back pain patients. Int J Behav Med 1996;3:91–103.
20. Pincus T, Burton AK, Vogel S, Field AP. A systematic review of psychosocial factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine 2002;27:109-20.
21. Koleck M, Mazaux JM, Rascle N, Bruchon-Schweitzer M. Psycho-social factors and coping strategies as predictors of chronic evolution and quality of life in patients with low back pain: a prospective study. Eur J Pain 2006;10:1-11.
22. Clinical Standards Advisory Group Committee on Back Pain. Back pain: Report of a CSAG committee on back pain. London: HMSO, 1994:1–89.
23. Fritz JM, Irrgang JJ. A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale. Phys Ther 2001;81:776-88.
24. Kocyiğit H, Aydemir O, Fişek G, Ölmez N, Memiş A. Kısa Form-36 (KF-36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi 1999;12:102-16.
25. Hisli N. Beck Depresyon Ölçeğinin bir Türk örnekleminde geçerlilik ve güvenirliliği. Psikoloji Derg 1988;6:118-22.
26. Lamé IE, Peters ML, Vlaeyen JWS, Kleef M, Patijn J. Quality of life in chronic pain is more associated with beliefs about pain, then with pain intensity. Eur J Pain 2005;9:15-24.
27. Rudy TE, Kerns RD, Turk DC. Chronic pain and depression: Toward a cognitive-behavioral mediation model. Pain 1988;35:129-40.
28. Krishnan KRR, France RD, Davidson J. Depression as a psychological disorder in chronic pain. In: France RD, Krishnan KRR, (eds.): Chronic Pain. Washington DC: Am Psychiatric Pres. 1988: 195-219.
29. Haythornthwaite JA, Sieber WJ, Kerns RD. Depression and the chronic pain experience. Pain 1991;46:177-84.
30. Sayar K, Bilen A, Arıkan K. Kronik ağrı hastalarında öfke, benlik saygısı ve aleksitimi. Türk Klin Psikiyatri Derg 2001;2:36-42.
31. Yazıcı K, Tot Ş, Biçer A, Yazıcı A, Buturak V. Bel ve boyun ağrısı hastalarında anksiyete, depresyon ve yaşam kalitesi. Klinik Psikiyatri 2003;6:95-101.
32. Leino P, Magni G. Depressive and distress symptoms as predicts of low-back pain, neck-shoulder pain, and other musculoskeletal morbidity: A 10-year follow-up of metal industry employees. Pain 1993;53:89-94.
33. Waxman SE, Tripp DA, Flamenbaum R. The mediating role of depression and negative partner responses in chronic low back pain and relationship satisfaction. J Pain 2008;9:434-42.
34. Keeley P, Creed F, Tomenson B, Todd C, Borglin G, Dickens C. Psychosocial predictors of health-related quality of life and health service utilisation in people with chronic low back pain. Pain 2008;135:142–50.
35. Kirmayer LJ, Robbins JM, Dworkind M, Yaffe MJ. Somatization and the recognition of depression and anxiety in primary care. Am J Psychiatry 1993;150:734–41. 36. Corruble E, Guelfi JD. Pain complaints in depressed inpatients. Psychopathol 2000;33:307–9. 37. Lépine JP, Briley M. The epidemiology of pain in depression. Hum Psychopharmacol 2004;19:S3-7.
38. Patten SB. Long-term medical conditions and major depression in a Canadian population study at waves 1 and 2. J Affect Disord 2001;63:35–41.
39. Dohrenwend BP, Raphael KG, Marbach JJ, Gallagher RM. Why is depression comorbid with chronic myofascial face pain? A family study test of alternative hypotheses. Pain 1999;83:183-92.
40. Wells KB, Stewart A, Hays R, Burnam MA, Rogers W, Daniels MD, et al. The functioning and well-being of depressed patients. Results from the medical outcome study. JAMA 1989;262: 914-9.
41. Ormel J, Von Korff M, Van den Brink W, Katon W, Brilman E, Oldehinkel T. Depression, anxiety and social disability show synchrony of change in primary care patients. Am J Public Health 1993;83:385-90.
42. Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K. Functioning and well-being outcomes of depressed patients with depression compared with chronic general medical illnesses. Arch of Gen Psychiatry 1995;52:11-9.
43. Rush AJ, Polatin P, Gatchel RJ. Depression and chronic low back pain establishing priorities in treatment. Spine 2000;25:2566-71.