Depressive and distress symptoms as predictors of low back pain, neck-shoulder pain, and other musculoskeletal morbidity: A 10-year follow-up of metal industry employees

Health Research Department, LEL Employment Pension Fund, SF-00241 HelsinkiFinland
Pain (Impact Factor: 5.21). 05/1993; 53(1):89-94. DOI: 10.1016/0304-3959(93)90060-3


Six-hundred-seven employees in 3 metal industry plants were studied for depressive and distress symptoms, musculoskeletal symptoms, and findings in the musculo-skeletal system made by a physiotherapist. Measurements were made 3 times at 5-year intervals. The mean distress and depressive symptom scores of the first 2 examinations predicted the change in several musculo-skeletal symptom measures during the second 5-year period, when the effects of age and occupational class were accounted for in multiple regression analysis. They also predicted the development in clinical musculoskeletal findings in men. The proportions of variance explained by the depressive and distress symptoms were modest in magnitude. Analogous analyses were made with reference to the reverse temporal sequence: musculoskeletal disorders were considered as predating the development in depressive and distress symptoms. The musculoskeletal symptom scores were associated with the change in the stress symptoms in men, as did the clinical findings in the neck-shoulder and low back regions. None of the musculoskeletal morbidity scores predicted the change in the depressive symptoms in either sex. We conclude that depressive symptoms predict future musculoskeletal disorders, but not vice versa, whereas the association of stress symptoms and musculoskeletal disorders is reciprocal.

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    • "Three mechanisms have been hypothesized to explain the association of depressive and anxiety disorders with somatic symptoms. First, in the antecedent hypothesis, depressive and anxiety disorders cause the onset of somatic symptoms [16] [17] [18] [19] via, for example, an increased awareness and an altered perception of physical sensations [20] [21]. "
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    ABSTRACT: Previous studies have shown that depressive and anxiety disorders are strongly related to somatic symptoms, but much is unclear about the specificity of this association. This study examines the associations of specific depressive and anxiety disorders with somatic symptoms, and whether these associations are independent of comorbid depressive and anxiety disorders.Methods Cross-sectional data were derived from the Netherlands Study of Depression and Anxiety (NESDA). A total of 2008 persons (mean age: 41.6 years, 64.9% women) were included, consisting of 1367 patients with a past-month DSM-diagnosis (established with the Composite International Diagnostic Interview [CIDI]) of depressive disorder (major depressive disorder, dysthymic disorder) and/or anxiety disorder (generalized anxiety disorder, social phobia, panic disorder, agoraphobia), and 641 controls. Somatic symptoms were assessed with the somatization scale of the Four-Dimensional Symptom Questionnaire (4DSQ), and included cardiopulmonary, musculoskeletal, gastrointestinal, and general symptoms. Analyses were adjusted for covariates such as chronic somatic diseases, sociodemographics, and lifestyle factors.ResultsAll clusters of somatic symptoms were more prevalent in patients with depressive and/or anxiety disorders than in controls (all p < .001). Multivariable logistic regression analyses showed that all types of depressive and anxiety disorders were independently related to somatic symptoms, except for dysthymic disorder. Major depressive disorder showed the strongest associations. Associations remained similar after adjustment for covariates.Conclusion This study demonstrated that depressive and anxiety disorders show strong and partly differential associations with somatic symptoms. Future research should investigate whether an adequate consideration and treatment of somatic symptoms in depressed and/or anxious patients improves treatment outcomes.
    Full-text · Article · Nov 2014 · Journal of Psychosomatic Research
    • "Aging being a strong risk factor for MSD, psychological and emotional stresses would also have a contributory role in the initiation and aggravation of MSD.[18] It has been suggested that the presence of depressive symptoms predicts future MSDs but not vice versa.[19] A clear link is established between psychological variables with neck and back pain. "
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    ABSTRACT: Background:Work related musculoskeletal disorders (MSDs) are one of the common occupational hazards among health care providers.Aim:The objective of this study was to evaluate MSDs in terms of perception of pain experienced by physicians, surgeons and dental surgeons during professional work.Subjects and Methods:The study was conducted with 100 physicians practicing either modern or alternative medicine, 100 surgeons of various specialties and 100 dental surgeons. Self-reporting work related questionnaire on MSDs were distributed, including information on the location of MSD symptoms in the past 12 months and the pain experienced.Results:Musculoskeletal pain was most prevalent among dentists 61% (61/100), followed by surgeons 37% (37/100) and physicians 20% (20/100). Nearly 15% of physicians (3/20), 40% (15/37) of Surgeons and 60% (35/61) of Dentists had MSD problems in more than one site.Conclusion:Within the limitations of the study, there is a higher prevalence of MSDs experienced by dental surgeons than physicians and surgeons. More research is needed on musculoskeletal problems with dental surgeons and other specialty doctors with an emphasis on a larger sample sizes and correlating other factors such as age and sex of the doctor, duration of practice, working hours per week, physical activity and working environment.
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    • "In addition, they wear heavy personal protective gear and work in narrow, dangerous spaces that impose physical stress on their shoulders, lower back, and knees. Such a poor working environment increases the possibility of musculoskeletal symptoms [38], and psychological stress can have a combined affect on the occurrence of musculoskeletal symptoms [36,37]. The musculoskeletal symptoms caused by mental and physical stress can directly affect sleep quality through pain [6], but chronic musculoskeletal symptoms, as mentioned above, can increase depression symptoms [27] and indirectly affect sleep quality simultaneously. "
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    ABSTRACT: Objectives The aim of this study was to investigate factors associated with sleep disorders in male firefighters working in a metropolitan city in South Korea. Methods Self-administered questionnaires including the Nordic Musculoskeletal Questionnaire, Korean Occupational Stress Scale-Short Form, Psychosocial Well-Being Index-Short Form, Pittsburg Sleep Quality Index, and Beck-Depression Inventory-2 as well as surveys collecting socio-demographic characteristics and work-related factors were given to 730 male firefighters. After exclusion for missing data, 657 male firefighters were included, and logistic regression analysis adjusted for the work-related factors, psychosocial factors, and general risk factors were used to assess the relationship between sleep disorders and associated factors. Results The prevalence of sleep disorders was 48.7%. Shift work (adjusted OR 1.58, 95% CI = 1.02-2.45), musculoskeletal symptoms (adjusted OR 2.89, 95% CI = 2.02-4.14), and depression (adjusted OR 7.04 95% CI = 4.03-12.30) were associated with sleep disorders. Conclusions Musculoskeletal symptoms, shift work, and depression are associated with sleep disorders. Integrated health management is needed to promote good sleep quality among firefighters.
    Full-text · Article · May 2014
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