Bidirectional Comorbid Associations between Back Pain and Major Depression in US Adults
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Measurements
2.2.1. Back Pain
2.2.2. Major Depression
2.2.3. Health Behaviors
2.2.4. Demographic and Socioeconomic Characteristics
2.3. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Cross-Sectional Multivariable Associations
3.3. Longitudinal Associations
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Detailed Information on the Measurements
References
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% in General Sample at T1 | Back Pain at T-1 (%) | p | Major Depression at T-1 (%) | p | ||
---|---|---|---|---|---|---|
Health outome | ||||||
Major depression at T-1 | <0.001 | |||||
No | 89.5 | 20.8 | ||||
Yes | 10.5 | 37.4 | ||||
Back pain at T-1 | <0.001 | |||||
No | 77.5 | 8.5 | ||||
Yes | 22.5 | 17.4 | ||||
Demographic characteristic | ||||||
Age | 0.049 | <0.001 | ||||
30–49 | 35.0 | 20.8 | 13.6 | |||
50–59 | 28.8 | 21.8 | 12.1 | |||
60–75 | 36.2 | 24.8 | 6.2 | |||
Sex | 0.005 | <0.001 | ||||
Male | 45.5 | 20.4 | 6.1 | |||
Female | 54.5 | 24.4 | 14.1 | |||
Race/Ethnicity | 0.901 | 0.731 | ||||
Others | 8.1 | 22.8 | 11.0 | |||
Non-Hispanic White | 91.9 | 22.5 | 10.4 | |||
Socioeconomic status | ||||||
Education | <0.001 | 0.01 | ||||
High school or less | 30.9 | 27.4 | 12.3 | |||
Some college | 21.0 | 23.8 | 11.5 | |||
College and more | 48.0 | 18.9 | 8.9 | |||
Personal earning | <0.001 | <0.001 | ||||
<$19,999 | 32.4 | 29.3 | 14.1 | |||
$20,000–$59,999 | 44.2 | 20.9 | 9.8 | |||
$60,000–$200,000+ | 23.0 | 16.3 | 6.8 | |||
Health behavior | ||||||
Leisure-time physical activity | <0.001 | 0.342 | ||||
Active | 20.0 | 17.8 | 9.0 | |||
Insufficiently active | 37.0 | 21.4 | 10.9 | |||
Inactive | 42.0 | 25.8 | 10.9 | |||
Tobacco use | <0.001 | <0.001 | ||||
No | 85.0 | 21.2 | 8.9 | |||
Yes | 15.0 | 30.0 | 19.6 | |||
Alcohol consumption | 0.006 | 0.012 | ||||
Non drinkers | 40.1 | 25.3 | 12.3 | |||
Light to moderate drinkers | 45.1 | 20.9 | 8.9 | |||
Heavy drinkers | 14.8 | 20.0 | 10.2 | |||
Obesity | <0.001 | 0.083 | ||||
No | 68.6 | 20.4 | 9.9 | |||
Yes | 31.4 | 27.1 | 11.8 |
Model 1: Association between Major Depression at T-1 and Back Pain at T-1 * | |||
---|---|---|---|
aORs | 95% CI | p | |
Major depression at T-1 | 2.13 | (1.68, 2.71) | <0.001 |
Model 2: Association between Back Pain at T-1 and Major Depression at T-1 * | |||
aORs | 95% CI | p | |
Back pain at T-1 | 2.11 | (1.66, 2.69) | <0.001 |
Model 3: Longitudinal Association between Back Pain at T-1 and Major Depression at T-2 | ||||||
---|---|---|---|---|---|---|
Major Depression at T-2 (%) | p | PR | 95% CI | p | ||
Health outcome | ||||||
Back pain at T-1 | <0.001 | |||||
No | 22.5 | 1.00 | ||||
Yes | 39.0 | 1.96 | (1.41, 2.74) | <0.001 | ||
Demographic characteristic | ||||||
Age | <0.001 | |||||
30–49 | 11.8 | 1.00 | ||||
50–59 | 9.9 | 0.81 | (0.56, 1.17) | 0.26 | ||
60–75+ | 5.3 | 0.55 | (0.37, 0.83) | 0.01 | ||
Sex | <0.001 | |||||
Male | 5.6 | 1.00 | ||||
Female | 11.8 | 1.87 | (1.32, 2.65) | <0.001 | ||
Socioeconomic status | ||||||
Education | 0.134 | |||||
High school or less | 10.4 | 1.00 | ||||
Some college | 10.0 | 1.29 | (0.79, 2.09) | 0.31 | ||
College and more | 8.0 | 0.88 | (0.62, 1.26) | 0.49 | ||
Personal earning | <0.001 | |||||
<$19,999 | 13.2 | 1.00 | ||||
$20,000-$59,999 | 8.1 | 0.82 | (0.56, 1.2) | 0.31 | ||
$60,000-$200,000+ | 5.6 | 0.84 | (0.55, 1.29) | 0.43 | ||
Health behavior | ||||||
Leisure-time physical activity | 0.308 | |||||
Inactive | 7.7 | 1.00 | ||||
Insufficiently active | 10.0 | 1.27 | (0.89, 1.81) | 0.18 | ||
Active | 8.9 | 0.91 | (0.56, 1.46) | 0.69 | ||
Tobacco use | <0.001 | |||||
No | 8.0 | 1.00 | ||||
Yes | 16.2 | 1.75 | (1.17, 2.62) | 0.01 | ||
Alcohol consumption | 0.027 | |||||
Heavy drinkers | 10.8 | 1.00 | ||||
Light to moderate drinkers | 7.5 | 0.62 | (0.40, 0.99) | 0.04 | ||
Non drinkers | 9.5 | 0.75 | (0.48, 1.20) | 0.23 | ||
Obesity | 0.009 | |||||
No | 8.1 | 1.00 | ||||
Yes | 11.3 | 1.37 | (0.98, 1.91) | 0.07 |
Model 4: Longitudinal Association between Major Depression at T-1 and Back Pain at T-2 | ||||||
---|---|---|---|---|---|---|
Back Pain at T-2 (%) | p | PR | 95% CI | p | ||
Health outcome | ||||||
Major depression at T-1 | <0.001 | |||||
No | 7.4 | 1.00 | ||||
Yes | 15.4 | 1.48 | (1.04, 2.12) | 0.03 | ||
Demographic characteristic | ||||||
Age | 0.014 | |||||
30–49 | 21.1 | 1.00 | ||||
50–59 | 24.0 | 1.23 | (0.92, 1.63) | 0.16 | ||
60–75+ | 27.3 | 1.39 | (1.05, 1.84) | 0.02 | ||
Sex | 0.019 | |||||
Male | 21.8 | 1.00 | ||||
Female | 26.0 | 1.07 | (0.85, 1.34) | 0.57 | ||
Socioeconomic status | ||||||
Education | <0.001 | |||||
High school or less | 31.3 | 1.00 | ||||
Some college | 25.1 | 1.00 | (0.69, 1.44) | 1.00 | ||
College and more | 20.0 | 0.95 | (0.75, 1.21) | 0.68 | ||
Personal earning | <0.001 | |||||
<$19,999 | 28.9 | 1.00 | ||||
$20,000–$59,999 | 24.5 | 0.96 | (0.74, 1.26) | 0.79 | ||
$60,000–$200,000+ | 17.6 | 1.07 | (0.80, 1.43) | 0.64 | ||
Health behavior | ||||||
Leisure-time physical activity | <0.001 | |||||
Inactive | 19.3 | 1.00 | ||||
Insufficiently active | 21.4 | 0.79 | (0.61, 1.02) | 0.08 | ||
Active | 29.3 | 0.82 | (0.61, 1.11) | 0.21 | ||
Tobacco use | 0.002 | |||||
No | 23.1 | 1.00 | ||||
Yes | 31.0 | 1.03 | (0.74, 1.45) | 0.85 | ||
Alcohol consumption | 0.004 | |||||
Heavy drinkers | 26.6 | 1.00 | ||||
Light to moderate drinkers | 20.9 | 0.72 | (0.53, 0.99) | 0.05 | ||
Non drinkers | 27.4 | 0.82 | (0.59, 1.13) | 0.23 | ||
Obesity | 0.002 | |||||
No | 22.3 | 1.00 | ||||
Yes | 28.3 | 1.23 | (0.97, 1.57) | 0.09 |
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Yang, H.; Hurwitz, E.L.; Li, J.; de Luca, K.; Tavares, P.; Green, B.; Haldeman, S. Bidirectional Comorbid Associations between Back Pain and Major Depression in US Adults. Int. J. Environ. Res. Public Health 2023, 20, 4217. https://doi.org/10.3390/ijerph20054217
Yang H, Hurwitz EL, Li J, de Luca K, Tavares P, Green B, Haldeman S. Bidirectional Comorbid Associations between Back Pain and Major Depression in US Adults. International Journal of Environmental Research and Public Health. 2023; 20(5):4217. https://doi.org/10.3390/ijerph20054217
Chicago/Turabian StyleYang, Haiou, Eric L. Hurwitz, Jian Li, Katie de Luca, Patricia Tavares, Bart Green, and Scott Haldeman. 2023. "Bidirectional Comorbid Associations between Back Pain and Major Depression in US Adults" International Journal of Environmental Research and Public Health 20, no. 5: 4217. https://doi.org/10.3390/ijerph20054217