Background Chronic pain in rheumatology often has a psychic impact, which may aggravate the daily life of patients. Chronic neck pain, as an example, is a frequent reason for consultation.
Objectives To assess the prevalence of anxiety and depression in patients with neck pain, and identify risk factors associated with their occurrence.
Methods It was a cross-sectional study that concerned 80 patients with neck pain lasting for more than 3 months, and seen during the consultations of rheumatology. All patients with symptomatic neck pain or having psychological history or receiving psychotropic medication were excluded from the study. For each patient, we determined the sociodemographic characteristics: age, gender, educational level, marital status, profession, working hours per day, exercise practice, and clinical characteristics: pain, functional discomfort and disability on a visual analogue scale (VAS). The anxious and depressed mood was assessed by the Hospital Anxiety and Depression Scale (HAD), which can detect anxiety and depressive disorders. It contains 14 items rated from 0 to 3: Seven refer to anxiety (Subscale A) and seven refer to depression (Subscale D). Each subscale score ranges from 0 to 21. If the score HAD (A) is >10, the patient was considered anxious, and if the score HAD (D) >8, the patient was considered depressed. The physicopsychic support was assessed by a single question. Statistical analysis was done to assess the descriptive characteristics and the association between HAD and different items.
Results Of the 80 patients, 67 (83.80%) were women. The average age of our population was 51.76±11.78 years [25, 74]. The median duration of progression of symptoms was 24 months [12, 48]. The mean VAS pain was 63.87% ±12.47, the mean VAS functional discomfort was 60.87% ±14.24 and the mean VAS disability was 59.75% ±14.66. The number of active patients was 65 (81.30%) with an average working hours per day of 7.52 hours ±1.96. Among the 80 patients enrolled, 32 (40%) were illiterate and 18 (22.50%) had university level. Celibacy was noted in 6 (7.50%) neck pain patients. A state of anxiety was found in 54 (68.4%) and 44 (55.7%) patients were depressed. A low level of education had a statistically significant relationship with anxiety (p=0.04; Expβ =6; CI95%: 1.03 to 34.84) and depression (p=0.03; Expβ =5; CI95%: 1.09 to 22.82). VAS disability was statistically linked to anxiety (p=0.01; Expβ =1.04, CI95%: 1.009 to 1.085). The cervicobrachial neuralgia was significantly associated with depression (p=0.02; Expβ =0.3, CI95%: 0.10 to 0.83). Anxiety and depression were two psychological factors which were significantly associated with p=0,01.
Conclusions This study suggests that the disability caused by chronic neck pain can have a significant psychological impact which is more pronounced with a low level of education. Further larger studies are needed to assess other risk factors probably related to anxiety and depression in neck pain patients.
Disclosure of Interest None declared