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
Damla CANKURTARANa, Zeynep AYKIN YIĞMANb
aSağlık Bilimleri Üniversitesi Dışkapı Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, TÜRKİYE
bPolatlı Duatepe Devlet Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, TÜRKİYE
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.
Anahtar Kelimeler: Boyun ağrısı; bel ağrısı; anksiyete; depresyon; kronik ağrı
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.
Keywords: Neck pain; low back pain; anxiety; depression; chronic pain
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