Advertisement

Canadian Journal of Public Health

, Volume 91, Issue 6, pp 459–464 | Cite as

The Saskatchewan Health and Back Pain Survey: The Prevalence and Factors Associated with Depressive Symptomatology in Saskatchewan Adults

  • Linda J. Carroll
  • J. David Cassidy
  • Pierre Côté
Article

Abstract

Objectives: To determine the one-week period prevalence of depressive symptomatology among Saskatchewan adults and to identify sociodemographic and health factors associated with depressive symptomatology.

Methods: The Saskatchewan Health and Back Pain Survey was mailed to an age-stratified random sample of adults. Of the 2,184 eligible subjects, 55% (n=1131) responded to the survey. We report age-standardized prevalence estimates stratified by age, gender and spinal pain severity. Logistic regression was used to measure the presence and strength of association between various factors and depressive symptomatology.

Results: 22.2% (95% CI 19.6–24.9) of adults experienced depressive symptomatology during the previous week, with higher rates in younger adults, in females, and in those with disabling spinal pain. Depressive symptomatology was associated with age, income, smoking, health status, gastro-intestinal problems, headaches and spinal pain.

Conclusions: Depressive symptomatology is common in the Saskatchewan adult population, and is related to age, pain severity and general health.

Résumé

Objectifs: L’étude visait à déterminer le taux de prévalence, sur une période d’une semaine, des symptômes dépressifs chez les adultes de la Saskatchewan et à préciser les facteurs sociodémographiques et de santé qui leur sont associés.

Méthode: L’analyse portait sur un échantillon aléatoire d’adultes répartis en catégories d’âge, à qui nous avons expédié un sondage sur la santé et les douleurs dorsales en Saskatchewan. Sur les 2 184 personnes ayant reçu le sondage, 55 % (n = 1 131) ont répondu au questionnaire. Nous avons établi des taux de prévalence globaux et selon le groupe d’âge, le sexe et la gravité de la douleur spinale. Nous avons utilisé la régression logistique pour évaluer la présence et, le cas échéant, la force des liens entre divers facteurs et les symptômes dépressifs.

Résultats: 22,2 % (95 % IC 19,6–24,9) des adultes ont ressenti des symptômes de dépression au cours de la semaine qui a précédé l’étude. Les jeunes adultes, les femmes et les personnes souffrant de douleurs spinales invalidantes ont présenté les taux les plus élevés. Les symptômes dépressifs sont associés à l’âge, au revenu, au tabagisme, à l’état de santé, aux problèmes gastro-intestinaux, aux maux de tête et aux douleurs spinales.

Conclusion: Les symptômes dépressifs sont courants dans la population adulte de la Saskatchewan et sont liés à l’âge, à la gravité de la douleur et à l’état de santé général.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Johnson J, Weissman MM, Klerman, GL. Service utilization and social morbidity associated with depressive symptoms in the community. JAMA 1992;267:1478–83.CrossRefPubMedGoogle Scholar
  2. 2.
    Crum RM, Cooper-Patrick L, Ford, DE. Depressive symptoms among general medical patients: Prevalence and one-year outcome. Psychosomatic Medicine 1994;56:109–17.CrossRefPubMedGoogle Scholar
  3. 3.
    Horwath E, Johnson J, Klerman GL, Weissman MM. Depressive symptoms as relative and attributable risk factors for first-onset major depression. Arch Gen Psychiatry 1992;49:817–23.CrossRefPubMedGoogle Scholar
  4. 4.
    Wells KB, Burnam MA, Rogers W, et al. The course of depression in adult outpatients. Results from the Medical Outcomes Study. Arch Gen Psychiatry 1992;49:788–94.CrossRefPubMedGoogle Scholar
  5. 5.
    Broadhead WE, Blazer DG, George LK, Tse, CK. Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA 1990;264:2524–28.CrossRefPubMedGoogle Scholar
  6. 6.
    Frombonne E. Increased rates of depression: Update of epidemiological findings and analytical problems. Acta Psychiatrica Scandinavica 1994;90:145–56.CrossRefGoogle Scholar
  7. 7.
    Henderson JG, Pollard, CA. Prevalence of various depressive symptoms in a sample of the general population. Psychological Reports 1992;71:208–10.CrossRefGoogle Scholar
  8. 8.
    Regier DA, Boyd JH, Burke JD, et al. Onemonth prevalence of mental disorders in the United States. Based on five epidemiologic catchment areas. Arch Gen Psychiatry 1988;45:977–86.CrossRefPubMedGoogle Scholar
  9. 9.
    Robins LN, Helzer JE, Weissman MM, et al. Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry 1984;41:949–58.CrossRefGoogle Scholar
  10. 10.
    Culbertson, FM. Depression and gender: An international review. American Psychologist 1997;52:25–31.CrossRefGoogle Scholar
  11. 11.
    Gatz M, Johansson B, Pedersen N, et al. A crossnational self-report measure of depressive symptomatology. International Psychogeriatrics 1993;5:147–56.CrossRefGoogle Scholar
  12. 12.
    Kessler RC, Foster C, Webster PS, House, JS. The relationship between age and depressive symptoms in two national surveys. Psychology and Aging 1992;7:119–26.CrossRefGoogle Scholar
  13. 13.
    France RD, Houpt JL, Skott A, et al. Depression as a psychopathological disorder in chronic low back pain patients. J Psychosomatic Research 1986;30:127–33.CrossRefGoogle Scholar
  14. 14.
    Herr KA, Mobily PR, Smith C. Depression and the experience of chronic back pain: A study of related variables and age differences. Clin J Pain 1993;9:104–14.CrossRefGoogle Scholar
  15. 15.
    Love, AW. Depression in chronic low back pain patients: Diagnostic efficiency of three self-report questionnaires. J Clin Psychol 1987;43:84–89.Google Scholar
  16. 16.
    Magni G, Marchetti M, Moreschi C, et al. Chronic musculoskeletal pain and depressive symptoms in the National Health and Nutrition Examination. I. Epidemiologic Follow-up Study. Pain 1993;43:299–307.CrossRefGoogle Scholar
  17. 17.
    Rajala U, Keinänen-Kiukaanniemi S, Uusimäki A, Kivelä SL. Musculoskeletal pains and depression in a middle-aged Finnish population. Pain 1995;61:451–57.CrossRefGoogle Scholar
  18. 18.
    Sullivan MJL, D’Eon J. Relation between catastrophizing and depression in chronic pain patients. J Abnormal Psychology 1990;99:260–63.CrossRefGoogle Scholar
  19. 19.
    Turner JA, Romano, JM. Self-report screening measures for depression in chronic pain patients. J Clin Psychol 1984;40:909–13.CrossRefGoogle Scholar
  20. 20.
    von Korff M, Dworkin SF, Le Resche L. Graded chronic pain status: An epidemiologic evaluation. Pain 1990;40:279–91.CrossRefGoogle Scholar
  21. 21.
    von Korff M, Ormel J, Keefe FJ, Dworkin, SF. Grading the severity of chronic pain. Pain 1992;50:133–49.CrossRefGoogle Scholar
  22. 22.
    Côté P, Cassidy JD, Carroll, LC. The Saskatchewan Health and Back Pain Survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine 1998;23:1689–98.CrossRefGoogle Scholar
  23. 23.
    Radloff, LS. The CES-D scale. A self-reported depression scale for research in the general population. Appl Psychol Measurement 1977;1:385–401.CrossRefGoogle Scholar
  24. 24.
    Orme JG, Reis J, Herz, EJ. Factorial and discriminant validity of the Center for Epidemiological Studies Depression (CES-D) Scale. J Clin Psychol 1986;42:28–33.CrossRefGoogle Scholar
  25. 25.
    Devins GM, Orme CM, Costello CG, et al. Measuring depressive symptoms in illness populations: Psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) Scale. Psychology and Health 1988;2:139–56.CrossRefGoogle Scholar
  26. 26.
    Weissman MM, Sholomskas D, Pottenger M, et al. Assessing depressive symptoms in five psychiatric populations: A validation study. Am J Epidemiol 1977;106:203–14.CrossRefGoogle Scholar
  27. 27.
    Blalock SJ, DeVellis RF, Brown GK, Wallston KA. Validity of the Center for Epidemiological Studies Depression Scale in arthritis populations. Arthritis and Rheumatism 1989;32:991–97.CrossRefGoogle Scholar
  28. 28.
    Turk DC, Okifuji A. Detecting depression in chronic pain patients: Adequacy of self-reports. Behavior Research and Therapy 1994;32:9–16.CrossRefGoogle Scholar
  29. 29.
    Boyd JH, Weissman MM, Thompson WD, Myers, JK. Screening for depression in a community sample. Arch Gen Psychiatry 1982;39:1195–200.CrossRefGoogle Scholar
  30. 30.
    Schulberg HC, Saul M, McClellant M, et al. Assessing depression in primary medical and psychiatric practices. Arch Gen Psychiatry 1985;42:1164–70.CrossRefPubMedGoogle Scholar
  31. 31.
    von Korff M, Dworkin SF, Le Resche L, Kruger A. An epidemiologic comparison of pain complaints. Pain 1988;32:173–83.CrossRefGoogle Scholar
  32. 32.
    von Korff M, Le Resche L, Dworkin, SF. First onset of common pain symptoms: A prospective study of depression as a risk factor. Pain 1993;55:251–58.CrossRefGoogle Scholar
  33. 33.
    von Korff M, Deyo RA, Cherkin D, Barlow W. Back pain in primary care. Outcomes at one year. Spine 1993;18:855–62.CrossRefGoogle Scholar
  34. 34.
    Cassidy JD, Carroll LC, Côté P. The Saskatchewan Health and Back Pain Survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine 1998;23:1860–67.CrossRefPubMedGoogle Scholar
  35. 35.
    Ware JE, Snow KK, Kosinski M, Gandek B. Sf-36 Health Survey: Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center, 1993.Google Scholar
  36. 36.
    Brazier JE, Harper R, Jones NMB, et al. Validating the SF-36 Health Survey questionnaire: New outcome measure for primary care. Br Med J 1992;305:160–64.CrossRefGoogle Scholar
  37. 37.
    Garratt AM, Ruta DA, Abdalla MI, et al. The SF-36 health survey questionnaire: An outcome measure suitable for routine use within the NHS? Br Med J 1993;306:1440–44.CrossRefGoogle Scholar
  38. 38.
    Kurtin PS, Davie AR, Meyer KB, et al. Patientbased health status measures in outpatient dialysis: Early experiences in developing an outcomes assessment program. Medical Care 1992;30(Suppl):MS136–MS149.PubMedGoogle Scholar
  39. 39.
    McHorney CA, Ware JE, Rogers W, et al. The validity and relative precision of MOS Short- and Long-Form Health Status Scales and Dartmouth COOP Charts. Medical Care 1992;30:253–65.CrossRefGoogle Scholar
  40. 40.
    Katz JN, Larson MG, Phillips CB, et al. Comparative measurement sensitivity of short and longer health status instruments. Medical Care 1992;30:917–25.CrossRefGoogle Scholar
  41. 41.
    Kravitz RL, Greenfield S, Rogers WH, et al. Differences in the mix of patients among medical specialities and systems of care: Results from the Medical Outcomes Study. JAMA 1992;267:1617–23.CrossRefGoogle Scholar
  42. 42.
    Jenkinson C, Coulter A, Wright L. Short-form 36 (SF-36) Health Survey Questionnaire: Normative data for adults of working age. BMJ 1993;306:1437–40.CrossRefPubMedGoogle Scholar
  43. 43.
    Fryback DG, Dasbach EJ, Klein R, et al. The Beaver Dam health outcomes study: Initial catalog of health state quality factors. Medical Decision Making 1993;13:89–102.CrossRefGoogle Scholar
  44. 44.
    Jaroszynski G, Cassidy JD, Carroll L, et al. Development and validation of a comorbidity scale. Presented at the Canadian Orthopaedic Research Association, Quebec, June 1996.Google Scholar
  45. 45.
    Tennant A, Badley, EM. A confidence interval approach to investigating nonresponse bias and monitoring response to postal questionnaires. J Epidemiol Community Health 1991;47:15–29.Google Scholar
  46. 46.
    SPSS for Windows, Version 7.5. Chicago, IL: SPSS Inc., 1997.Google Scholar
  47. 47.
    Stata 5. College Station, Texas: Stata Corporation, 1997.Google Scholar
  48. 48.
    Roberts RE, Vernon, SW. The Center for Epidemiologic Studies Depression Scale: Its use in a community sample. Am J Psychiatry 1983;140:41–46.CrossRefGoogle Scholar
  49. 49.
    Husaini BA, Neff JA, Stone, RH. Psychiatric impairment in rural communities. J Community Psychology 1979;7:137–46.CrossRefGoogle Scholar
  50. 50.
    Boyd JH, Weissman, MM. Epidemiology of affective disorders. A reexamination and future directions. Arch Gen Psychiatry 1981;38:1039–46.CrossRefGoogle Scholar
  51. 51.
    Weissman MM, Bland R, Joyce PR, et al. Sex differences in rates of depression: Cross-national perspectives. J Affect Disord 1993;29:77–84.CrossRefGoogle Scholar
  52. 52.
    Kessler RC, McGonagle KA, Swartz M, et al. Sex and depression in the National Comorbidity Survey I: Lifetime prevalence, chronicity and recurrence. J Affect Disord 1993;29:85–96.CrossRefGoogle Scholar
  53. 53.
    Mirowsky J, Ross, CE. Age and depression. J Health Soc Behav 1992;33:187–205.CrossRefGoogle Scholar
  54. 54.
    Gatz M, Hurwica M-L. Are old people more depressed? Cross-sectional data on Center for Epidemiological Studies Depression Scale factors. Psychology and Aging 1990;5:284–90.CrossRefGoogle Scholar
  55. 55.
    Coulehan JL, Schulbert HC, Block MR, et al. Medical comorbidity of major depressive disorder in a primary medical practice. Arch Intern Med 1990;150:2362–67.CrossRefGoogle Scholar
  56. 56.
    Keitner GI, Ryan C, Miller IW, Normal, WH. Recovery and major depression. Am J Psychiatry 1992;149:93–99.CrossRefGoogle Scholar
  57. 57.
    Atkinson JH, Ingram RE, Kremer EF, Saccuszo DP. MMPI subgroups and affective disorder in chronic pain patients. J Nerv Ment Dis 1986;174:408–13.CrossRefGoogle Scholar
  58. 58.
    Dworking RH, Gitlin, MJ. Clinical aspects of depression in chronic pain patients. Clin J Pain 1991;7:79–94.CrossRefGoogle Scholar
  59. 59.
    Painter JR, Seres JL, Newman, RI. Assessing benefits of pain centers: Why some patients regress. Pain 1980;8:101–13.CrossRefGoogle Scholar
  60. 60.
    Kerns RD, Haythornthwaite, JA. Depression among chronic pain patients: Cognitivebehavioral analysis and effect on rehabilitation outcome. J Consult Clin Psychol 1988;56:870–76.CrossRefGoogle Scholar
  61. 61.
    Forrest AJ, Wolkind, SN. Masked depression in men with low back pain. Rheum Rehabil 1974;13:148–53.CrossRefGoogle Scholar
  62. 62.
    Dolce JJ, Crocker MJ, Doleys, DM. Predicting outcome among chronic pain patients. Behav Res Ther 1986;24:313–19.CrossRefGoogle Scholar
  63. 63.
    Glass R, Allan A, Uhlenhuth M, et al. Psychiatric screening in a medical clinic. Arch Gen Psychiatry 1978;35:1189–95.CrossRefGoogle Scholar
  64. 64.
    Nelsen A, Williams T. Depression in ambulatory medical patients; prevalence by self-report questionnaire and recognition by non-psychiatric physicians. Arch Gen Psychiatry 1980;37:999–1004.CrossRefGoogle Scholar
  65. 65.
    Zung W, Magill M, Moore J, George D. Recognition and treatment of depression in a family medicine practice. J Clin Psychiatry 1983;33:3–6.Google Scholar
  66. 66.
    von Korff M, Shapiro S, Burke J, et al. Anxiety and depression in a primary care clinic. Arch Gen Psychiatry 1987;44:152–56.CrossRefGoogle Scholar
  67. 67.
    Prestidge B, Lake C. Prevalence and recognition of depression among primary care outpatients. J Fam Pract 1987;25:67–72.Google Scholar
  68. 68.
    Barrett JE, Barrett JA, Oxman T, Gerber P. The prevalence of psychiatric disorders in a primary care practice. Arch Gen Psychiatry 1988;45:1100–106.CrossRefGoogle Scholar
  69. 69.
    Wells KB, Hays RD, Burman MA, et al. Detection of depressive disorder for patients receiving prepaid fee-for-service care: Results from the Medical Outcomes Study. JAMA 1989;262:3298–302.CrossRefGoogle Scholar
  70. 70.
    Coulehan JL, Schulbert HC, Block MR, et al. Medical comorbidity of major depressive disorder in a primary care medical practice. Arch Intern Med 1990;150:2362–67.CrossRefGoogle Scholar
  71. 71.
    Zung WWK, Broadhead WE, Roth, ME. Prevalence of depressive symptoms in primary care. J Family Practice 1993;37:337–44.Google Scholar
  72. 72.
    Lehtinen V, Joukamma M. Epidemiology of depression: Prevalence, risk factors and treatment situation. Acta Psychiatr Scand 1994;Suppl 377:7–10.CrossRefGoogle Scholar
  73. 73.
    Simon GE, von Korff M. Recognition, management and outcomes of depression in primary care. Arch Fam Med 1995;4:99–105.CrossRefPubMedGoogle Scholar
  74. 74.
    Angst J, Merikangas K. The depressive spectrum: Diagnostic classification and course. J Affect Disord 1997;45:31–40.CrossRefPubMedGoogle Scholar

Copyright information

© The Canadian Public Health Association 2000

Authors and Affiliations

  • Linda J. Carroll
    • 1
  • J. David Cassidy
    • 1
  • Pierre Côté
    • 2
    • 3
  1. 1.Alberta Centre for Injury Control and ResearchDepartment of Public Health SciencesEdmontonCanada
  2. 2.Institute for Work & HealthTorontoCanada
  3. 3.Department of Public Health SciencesUniversity of TorontoTorontoCanada

Personalised recommendations