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Depression, Anxiety, Alcohol Use Not Uncommon Among People with Chronic Back or Neck Pain

Back and neck pain are among the most common complaints in industrialized or developed countries. Statistics show that chances of having back pain within a one-year period is anywhere from 15 percent to 56 percent, depending on the country in which you live. For neck pain, the chances are between 12 percent and 34 percent. However, neck pain and back pain often go hand in hand.

Although there have been studies investigating people with mood disorders who had back pain, there have been no studies that have investigated the association of back and/or neck pain and mood, anxiety, or alcohol disorders in populations from several developed countries.

Researchers in this study examined data from 17 countries from all over the world. They had four goals: to estimate the 12-month prevalence of chronic back pain within the general population, to estimate the same prevalence among people who have mood, anxiety disorders, or alcohol dependence, to investigate which mental disorders were most prevalent among those with back and/or neck pain, to investigate the consistency across the 17 countries in the study. Eighteen populations were ultimately studied because China had two groups: one from Beijing and one in Shanghai.

All participants were interviewed, face-to-face, using the Composite International Diagnostic Interview (CIDI 3.0) that was developed to assess mental disorders, treatment, and possible risk factors. The disorders included major depression, generalized anxiety disorder (GAD), panic disorder, agoraphobia, post-traumatic stress disorder (PTSD), social phobia, alcohol abuse, or alcohol dependence. Participants were also asked questions adapted from the US Health International Survey about back or neck pain.

Results from the studied covered a very wide range. Although chronic back and/or neck pain was found in all 18 groups, the 12-month prevalence rate ranged from a low of 9.7 percent in Colombia to a high of 42.1 percent in the Ukraine. When analyzing the data for mood disorders and neck and back pain, there was an average of 4 percent to 11 percent prevalence, but it went as low as 2.5 percent in Lebanon to as high as 15.7 percent in the United States. Although other disorders were identified, there was a prevalence of mood and anxiety disorders, and alcohol abuse and dependency, not just depression as is commonly thought.

The authors concluded that this was the first cross-national, population-based study investigating chronic back or neck pain with mental disorders found that such chronic pain is not associated with only depression, but also anxiety and alcohol dependence or abuse. With this knowledge, doctors should be aware of these risks as they make their decisions on how to manage their patients.


Koen Demyttenaere et al. Mental Disorders Among Persons with Chronic Back or Neck Pain: Results from the World Mental Health Surveys. In Pain. June 2007. Vol. 129. No. 3. Pp. 235-255.

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