The comorbidity of mental and physical disorders with self-reported chronic back or neck pain: Results from the China Mental Health Survey

Yifeng Xu; Yan Wang; Jianhua Chen; Yanling He; Qingzhi Zeng; Yueqin Huang; Xiufeng Xu; Jin Lu; Zhizhong Wang; Xian Sun; Jing Chen; Feng Yan; Tao Li; Wanjun Guo; Guangming Xu; Hongjun Tian; Xiangdong Xu; Yanjuan Ma; Limin Wang; Mei Zhang; Yongping Yan; Bo Wang; Shuiyuan Xiao; Liang Zhou; Lingjiang Li; Yan Zhang; Hongguang Chen; Tingting Zhang; Jie Yan; Hua Ding; Yaqin Yu; Changgui Kou; Fujun Jia; Jian Liu; Zheli Chen; Ning Zhang; Xinbai Du; Xiangdong Du; Yue Wu; Guohua Li

doi:10.1016/j.jad.2019.08.089

The comorbidity of mental and physical disorders with self-reported chronic back or neck pain: Results from the China Mental Health Survey

J Affect Disord. 2020 Jan 1:260:334-341. doi: 10.1016/j.jad.2019.08.089. Epub 2019 Aug 29.

Authors

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

Affiliations

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.

PMID: 31521871
DOI: 10.1016/j.jad.2019.08.089

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.

Keywords: China mental health survey; Chronic back or neck pain; Comorbidity; Mental disorder; Physical disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
China / epidemiology
Chronic Disease
Chronic Pain / epidemiology*
Chronic Pain / psychology
Comorbidity
Female
Health Surveys
Humans
Logistic Models
Male
Mental Disorders / epidemiology*
Middle Aged
Neck Pain / epidemiology*
Neck Pain / psychology
Prevalence
Self Report
Surveys and Questionnaires
Young Adult