2006 issue 2

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Volume 15, issue 2

Original article

Analysis of depressive symptoms in patients with lumbar discopathy receiving conservative therapy or surgical treatment

KRZYSZTOF ROCH-RADZISZEWSKI1
1. Kliniki Rehabilitacji Wojskowego Szpitala Klinicznego w Bydgoszczy
Postępy Psychiatrii i Neurologii 2006; 15 (2): 81-70
Keywords: lumbar discopathy, depression, conservative therapy, surgical treatment

Abstract

Objectives. A relationship between pain and depression is commonly recognized. Patients with lumbar discopathy suffer from chronic spinal pain that may lead to depressive states. An assessment of depression severity not only enables to optimize the therapeutic process, but also may serve as an indirect measure of treatment efficacy. The aim of the study was to analyze depressive symptoms in patients with lumbar discopathy receiving either conservative therapy only or surgical treatment.

Methods. The sample studied consisted of 665 patients aged 16 to 76 years, suffering from lumbar discopathy at the L4-L5 and L5-S1 levels. Conservative therapy only was provided to 348patients, while 317 underwent surgical treatment. The patients were examined during their hospitalization and at an over 10-year follow-up. Three age groups were analyzed: of young (under the age of 30 years), middle-aged (31-50 years) and elderly (over the age of 50 years) patients. Depression severity was assessed using a self-report rating scale of depressive symptoms frequency.

Results. Patients with lumbar discopathy manifested severe depressive symptoms, particularly sleep disturbances, and impairment of concentration and decision-making ability. Depression severity was correlated with spinal pain ratings and with evaluation of the patients' "quality of life ". Their depressive symptoms severity increased with the duration of lumbar discopathy. More severe symptoms were found in younger and middle-aged patients than in the elderly, and in patients receiving conservative therapy as compared to those after surgery.

Conclusions. A relatively high level of depression severity in patients treated for lumbar discopathy was correlated with their self-rated spinal pain and quality of life. Moreover, depression severity was related to the patient 's age, duration of the condition, and type of treatment used.

Address for correspondence:
Dr Krzysztof Radziszewski, Klinika Rehabilitacji Wojskowego Szpitala Klinicznego, ul. Powstańców Warszawy 5, 85-901 Bydgoszcz, e-mail: radziszewski@wp.pl