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Biopsychosocial function analyses changes the assessment of the ability to work in patients on long-term sick-leave due to chronic musculoskeletal pain: the role of undiagnosed mental health comorbidity.

https://arctichealth.org/en/permalink/ahliterature116779
Source
Scand J Public Health. 2013 May;41(3):247-55
Publication Type
Article
Date
May-2013
Author
Patricia Olaya-Contreras
Jorma Styf
Author Affiliation
Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Sweden. patricia.olaya@orthop.gu.se
Source
Scand J Public Health. 2013 May;41(3):247-55
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Analgesics, Opioid - therapeutic use
Chronic Pain - drug therapy - epidemiology
Comorbidity
Cross-Sectional Studies
Female
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Musculoskeletal Pain - drug therapy - epidemiology
Prevalence
Reproducibility of Results
Sick Leave - statistics & numerical data
Sweden - epidemiology
Time Factors
Work Capacity Evaluation
Young Adult
Abstract
To study the prevalence of somatic and mental health comorbidity and the use of opioid medication among patients on long-term sick-leave due to chronic musculoskeletal pain (CMP); to compare an orthopaedic-based assessment of ability to work with a team assessment; to investigate the relationship between intensity of pain and psychosocial characteristics in this group.
A cross-sectional study was carried out with 174 consecutive patients on sick-leave for a mean of 21 months. All were referred from the Social Insurance Office for orthopaedic evaluation and assessment of the ability to work. Of them, only 83/174 patients were referred by the Office for psychiatric evaluation.
Neck pain was the main cause of disability. Patients with neck pain often suffered pain in more than two sites, and greater intensity of pain. Thirty-four percent of all participants had been prescribed opioid medication before consultation. Degrees of disability, unemployment, low degree of education and to be an immigrant were related to intensity of pain. Unrecognized psychiatric disorders changed the main cause of inability to work in 69% of patients who underwent both orthopaedic and psychiatric evaluation.
An evaluation based on biopsychosocial function is valuable in reaching an accurate assessment of the patient's diagnosis, and ability to work in CMP. Ability to work and degree of sick-leave in patients on long-term sick-leave is determined to a large extent by undiagnosed mental health comorbidities, and not solely somatic complaints.
PubMed ID
23361388 View in PubMed
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Cross-validation of the Depression, Anxiety, and Positive Outlook Scale (DAPOS) for clinical use.

https://arctichealth.org/en/permalink/ahliterature138414
Source
Clin J Pain. 2011 May;27(4):330-7
Publication Type
Article
Date
May-2011
Author
Patricia Olaya-Contreras
Jorma Styf
Mari Lundberg
Bengt Jansson
Author Affiliation
Department of Occupational Orthopedics, Sahlgrenska University Hospital, Per Dubbsgatan 14, Gothenburg, Sweden. patricia.olaya@orthop.gu.se
Source
Clin J Pain. 2011 May;27(4):330-7
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anxiety - diagnosis - etiology - psychology
Chi-Square Distribution
Chronic Disease
Depression - diagnosis - etiology - psychology
Factor Analysis, Statistical
Female
Humans
Male
Middle Aged
Musculoskeletal Diseases - complications
Pain - complications
Psychiatric Status Rating Scales
Psychometrics - methods
Questionnaires
Reproducibility of Results
Sex Factors
Sweden - epidemiology
Time Factors
Young Adult
Abstract
The main objective of this study was to investigate different psychometric properties of the Swedish version of the Depression, Anxiety, and Positive Outlook Scale (DAPOS) in patients with chronic musculoskeletal pain in an orthopedic setting.
A total of 449 participants took part in the study, including 288 patients with chronic musculoskeletal pain and 161 participants in a reference group. Internal consistency, convergent validity, and measurement invariance of the constructs of DAPOS were investigated across sex and diagnostic groups. The Beck Depression Inventory and the Spielberger Anxiety Inventory were used for measures of convergent validity. Multigroup confirmatory factor analysis was performed to test measurement invariance of the theoretical constructs of DAPOS.
Internal consistency was good for all 3 constructs, and correlations concerned with convergent validity were found to be acceptable to good. With regard to cross-validation, the 3 constructs of DAPOS were strictly measurement invariant with respect to sex. Across diagnostic groups, the constructs of anxiety and positive outlook were almost strictly measurement invariant, although there were some restrictions of measurement invariance for the construct of depression.
To be able to rely on an instrument with as few items as DAPOS, the cross-validation of its constructs for sex and diagnostic groups is a valuable information, particularly when investigated in patients with musculoskeletal pain. Based on these results, we recommend that DAPOS could replace longer and more time-consuming screening tests in clinical settings.
PubMed ID
21178595 View in PubMed
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Kinesiophobia among patients with musculoskeletal pain in primary healthcare.

https://arctichealth.org/en/permalink/ahliterature49551
Source
J Rehabil Med. 2006 Jan;38(1):37-43
Publication Type
Article
Date
Jan-2006
Author
Mari Lundberg
Maria Larsson
Helene Ostlund
Jorma Styf
Author Affiliation
Department of Orthopaedics, Division of Occupational Orthopaedics, Göteborg University, Sahlgrenska University Hospital, Sweden. mari.lundberg@orthop.gu.se
Source
J Rehabil Med. 2006 Jan;38(1):37-43
Date
Jan-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Female
Humans
Kinesthesis
Male
Middle Aged
Musculoskeletal Diseases - complications - psychology - rehabilitation
Pain - complications - psychology - rehabilitation
Pain Measurement
Phobic Disorders - etiology - psychology - therapy
Physical Therapy Modalities
Primary Health Care
Prospective Studies
Questionnaires
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVES: To describe the occurrence of kinesiophobia and to investigate the association between kinesiphobia and pain variables, physical exercise measures and psychological characteristics in patients with musculoskeletal pain. DESIGN: A prospective descriptive study involving 2 selected physiotherapy departments within a primary healthcare setting in the south-west of Sweden. PATIENTS: Included were 140 of 369 (38%) consecutive patients (aged between 18 and 65 years) with musculoskeletal pain. METHODS: Questionnaires including background data, pain variables, physical exercise measures and psychological characteristics were sent to the patients prior to their appointment with the physiotherapist. A simple and a multiple logistic regression model were performed to identify associations among the variables where kinesiophobia was defined as the dependent variable. RESULTS: A high degree of kinesiophobia and psychological distress were observed in approximately 50% of the responders. According to the simple logistic regression analysis the factors that seemed to be associated with kinesiophobia were interference, disability, pain severity, pain intensity, life control, affective distress, depressed mood and solicitous response. The multiple logistic regression analysis showed no significant associations. CONCLUSION: Kinesiophobia is a commonly seen factor among patients with musculoskeletal pain, which ought to be taken into consideration when designing and performing rehabilitation programmes.
PubMed ID
16548085 View in PubMed
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