Yifeng Xu1, Yan Wang1, Jianhua Chen1, Yanling He1, Qingzhi Zeng1, Yueqin Huang2, Xiufeng Xu3, Jin Lu3, Zhizhong Wang4, Xian Sun4, Jing Chen1, Feng Yan1, Tao Li5, Wanjun Guo5, Guangming Xu6, Hongjun Tian6, Xiangdong Xu7, Yanjuan Ma7, Limin Wang8, Mei Zhang8, Yongping Yan9, Bo Wang9, Shuiyuan Xiao10, Liang Zhou10, Lingjiang Li11, Yan Zhang11, Hongguang Chen12, Tingting Zhang12, Jie Yan13, Hua Ding13, Yaqin Yu14, Changgui Kou14, Fujun Jia15, Jian Liu16, Zheli Chen17, Ning Zhang18, Xinbai Du19, Xiangdong Du20, Yue Wu21, Guohua Li22. 1. Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China. 2. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China. Electronic address: huangyq@bjmu.edu.cn. 3. Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China. 4. Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China. 5. Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China. 6. Tianjin Anding Hospital, Tianjin, China. 7. The Fourth People's Hospital in Urumqi, Urumqi, China. 8. National Center for Chronic and NonCommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. 9. Department of Epidemiology, Air Force Medical University of the Chinese People's Liberation Army, Xi'an, China. 10. Department of Social Medicine and Health Management, School of Public Health, Central South University, Changsha, China. 11. Mental Health Institute, the Second Xiangya Hospital, Central-south University, Changsha, China. 12. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China. 13. Department of Biostatistics, School of Public Health, School of Government, and Institute of Social Science Survey, Peking University, Beijing, China. 14. Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China. 15. Guangdong Mental Health Center, Guangzhou, China. 16. The Seventh Hospital of Hangzhou, Hangzhou, China. 17. Huzhou Third People's Hospital, Huzhou, China. 18. Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China. 19. The Third People's Hospital of Qinghai Province, Xining, China. 20. Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China. 21. Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China. 22. Chifeng Anding Hospital, Chifeng, China.
Abstract
BACKGROUND: To investigate mental and physical health comorbidity with chronic back or neck pain in the Chinese population, and assess the level of disability associated with chronic back or neck pain. METHODS: Data were derived from a large-scale and nationally representative community survey of adult respondents on mental health disorders in China (n = 28,140). Chronic back or neck pain, other chronic pain conditions and chronic physical conditions were assessed by self-report. Mental disorders were assessed by the Composite International Diagnostic Interview (CIDI). Role disability during the past 30 days was assessed with the World Health Organization Disability Assessment Schedule (WHO-DAS-II). RESULTS: The 12-month prevalence of chronic back or neck pain was 10.8%. Most of respondents with chronic back or neck pain (71.2%) reported at least one other comorbid condition, including other chronic pain conditions (53.4%), chronic physical conditions (37.9%), and mental disorders (23.9%). It was found by logistic regression that mood disorders (OR = 3.7, 95%CI:2.8-4.8) showed stronger association with chronic back or neck pain than anxiety disorders and substance disorders. Most common chronic pains and physical conditions were significantly associated with chronic back or neck pain. Chronic back or neck pain was associated with role disability after controlling for demographics and for comorbidities. Physical and mental comorbidities explained 0.7% of the association between chronic back or neck pain and role disability. CONCLUSIONS: Chronic back or neck pain and physical-mental comorbidity is very common in China and chronic back or neck pain may increase the likelihood of other physical and mental diseases. This presents a great challenge for both clinical treatment and public health education. We believe that further study needs to be conducted to improve the diagnostic and management skills for comorbidity conditions.
BACKGROUND: To investigate mental and physical health comorbidity with chronic back or neck pain in the Chinese population, and assess the level of disability associated with chronic back or neck pain. METHODS: Data were derived from a large-scale and nationally representative community survey of adult respondents on mental health disorders in China (n = 28,140). Chronic back or neck pain, other chronic pain conditions and chronic physical conditions were assessed by self-report. Mental disorders were assessed by the Composite International Diagnostic Interview (CIDI). Role disability during the past 30 days was assessed with the World Health Organization Disability Assessment Schedule (WHO-DAS-II). RESULTS: The 12-month prevalence of chronic back or neck pain was 10.8%. Most of respondents with chronic back or neck pain (71.2%) reported at least one other comorbid condition, including other chronic pain conditions (53.4%), chronic physical conditions (37.9%), and mental disorders (23.9%). It was found by logistic regression that mood disorders (OR = 3.7, 95%CI:2.8-4.8) showed stronger association with chronic back or neck pain than anxiety disorders and substance disorders. Most common chronic pains and physical conditions were significantly associated with chronic back or neck pain. Chronic back or neck pain was associated with role disability after controlling for demographics and for comorbidities. Physical and mental comorbidities explained 0.7% of the association between chronic back or neck pain and role disability. CONCLUSIONS:Chronic back or neck pain and physical-mental comorbidity is very common in China and chronic back or neck pain may increase the likelihood of other physical and mental diseases. This presents a great challenge for both clinical treatment and public health education. We believe that further study needs to be conducted to improve the diagnostic and management skills for comorbidity conditions.