CoChat
Sign Up
Cited by 313Musculoskeletal pain and rehabilitationMental Health Treatment and AccessPsychosomatic Disorders and Their Treatments

Prevalence, onset, and risk of psychiatric disorders in men with chronic low back pain: A controlled study

Atkinson, Hampton J., Slater, Mark A., Patterson, Thomas L., Grant, Igor, Garfin, Steven R.·1991·Pain
DOI 10.1016/0304-3959(91)90175-w
Open this paper in CoChat — free account

Abstract

This study used structured diagnostic interviews and DSM-III criteria to assess lifetime prevalence and pre-morbid risk of psychiatric disorder in a sample of men with long-standing chronic back pain (CLPB) attending a primary care clinic. A control group of age and demographically matched men without history of back pain was also studied. Compared to controls, men with CLBP had significantly higher lifetime rates of major depression (32% vs. 16%), alcohol use disorder (64.9% vs. 38.8%), and a major anxiety disorder (30.9% vs. 14.3%). Almost all CLBP men ever experiencing a mood disorder reported recurrent, not single, episodes. The 6 month point prevalence of major depression, but not other disorders, was also significantly elevated for men with CLBP. In CLBP, the first episode of major depression generally (58.1%) followed pain onset. While the initial major depressive episode usually commenced within the first 2 years of established pain, late onset mood disorder was also common. By comparison in most cases (81%) onset of alcohol use disorders considerably preceded pain. When an age-matching procedure was used to gauge relative vulnerability to psychiatric illness in patients and controls, CLBP patients had significantly higher pre-pain rates of alcohol use disorder but not depression. After age of pain onset, CLBP subjects had over 9 times the risk of developing major depression, but had similar rates of developing alcoholism. We conclude that (1) alcohol use disorders rather than depression may increase risk of developing CLBP, and (2) risk of new onset and recurrent major depression remains high for men throughout their pain career. This suggests that psychological adaptation to long-standing pain may be less successful than previously thought, especially with regard to recurrent mood disorder.

Integrity signals

Registry

Crossref · 10.1016/0304-3959(91)90175-w

Cites

60 of 60 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In the general population, depression is associated with a wide range of health, mental health, and neurological conditions, such as chronic pain, headaches and migraines, diabetes, low testosterone, cardiovascular/cerebrovascular/small vessel ischemic disease, PD, MCI, and AD.

    “In the general population, depression is associated with a wide range of health, mental health, and neurological conditions, such as 1) chronic pain [71–75]; 2) headaches and migraines [76–79]; 3) diabetes [80–82]; 4) low testosterone [83–85]; 5) cardiovascular, cerebrovascular, and small vessel ischemic disease [86–92]; 6) PD [93]; 7) MCI [94–96]; and 8) AD [97].”

    From The Need to Separate Chronic Traumatic Encephalopathy Neuropathology from Clinical Features (2017) · cites this paper as [71]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Atkinson, H. J., Slater, M. A., Patterson, T. L., Grant, I., & Garfin, S. R.
Affiliations
United States Department of Veterans Affairs (US)
Corresponding author
Atkinson, Hampton J.
ORCID
Patterson, Thomas L.
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1991-05
Volume
45
Issue
2
Pages
111-121
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/0304-3959(91)90175-w
OpenAlex
W2071410402
Cited by
313
References
60
Citations by year
2026: 2 · 2025: 3 · 2024: 4 · 2023: 19 · 2022: 9 · 2021: 8 · 2020: 2 · 2019: 9 · 2018: 9 · 2017: 12 · 2016: 14 · 2015: 9 · 2014: 6 · 2013: 7 · 2012: 14
FWCI
6.29
Type
journal article
Language
en
Open access
closed
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
chronic low back pain, psychiatric comorbidity, major depressive disorder, alcoholism, anxiety disorders, mood disorders, depression onset, men
MeSH terms
Adult, Alcoholism, Back Pain, Mental Disorders, Chronic Disease, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Risk Factors, Prevalence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review