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Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Back Pain | Research

The mediating role of depressive symptoms among Turkish population related to gender and low back pain: evidence from a national health survey

Authors: Nadire Gülçin Yıldız, Halide Z. Aydin, Grace Sambo, Kemal Aydın, Hatice Yıldız, Ichtiarini Nurullita Santri, Yuniar Wardani, Bwanalori Mwamulima, Khoiriyah Isni, Yohane V. A. Phiri

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Low back pain (LBP), though non-life-threatening, burdens healthcare with treatment expenses and work hours lost. Globally, 70–84% experience it, with risk factors tied to societal structure, income, and living conditions, making it a leading cause of disability.

Methods

This study utilized data from the 2019 Türkiye Health Survey, which consisted of 17,084 individuals aged 15 and above. Our study focused on investigating the factors related to low back pain through a cross-sectional analysis. To analyze these factors, we employed binary multivariate logistic regression. Additionally, we conducted post-hoc analyses to assess the potential mediating effect of depressive symptoms on the relationship between low back pain and gender.

Results

We found that 31.9% of the population experienced low back pain, with women being 58% more likely [aOR = 1.58; 95% CI (1.45–1.73)] than men to report symptoms. Individuals aged 55 + years old had a 90% [aOR = 1.90; 95% CI (1.61–2.23)] chance of experiencing low back pain, indicating an age-related increase. In the general population, having depressive symptoms was 2.49 [95% CI (2.23–2.78)] times more likely associated with low back pain. Our mediation analysis showed that gender (i.e., women vs. men), indicated by direct effects with β-estimates e = 0.78, predicted the likelihood of low back pain. Additionally, the relationship between gender and low back pain, mediated through a history of depressive symptoms, had a significant total indirect effect (i.e., β-estimate given as e = 0.49). Specifically, a history of depressive symptoms accounted for 17.86% [95% CI (9.67–20.10)] of the association between women having a higher likelihood of low back pain compared to men.

Conclusion

We observed that a higher likelihood of low back pain associated with gender and aging. Additionally, BMI served as a significant predictor, particularly in adults. Depression mediated the association between gender and low back pain. Acknowledging these associations may help identify and address contributing factors to LBP, potentially increasing awareness and alleviating the burden. Policymakers and healthcare professionals may consider these findings when developing prevention and treatment programs for low back pain.
Literature
1.
go back to reference Hoy D, et al. The global burden of low back pain: estimates from the global burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968.PubMedCrossRef Hoy D, et al. The global burden of low back pain: estimates from the global burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968.PubMedCrossRef
2.
go back to reference Murray CJ, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of Disease Study 2010. Lancet. 2012;380(9859):2197–223.PubMedCrossRef Murray CJ, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of Disease Study 2010. Lancet. 2012;380(9859):2197–223.PubMedCrossRef
3.
go back to reference Cieza A, et al. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the global burden of Disease Study 2019. Lancet. 2021;396(10267):2006–17.PubMedCrossRef Cieza A, et al. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the global burden of Disease Study 2019. Lancet. 2021;396(10267):2006–17.PubMedCrossRef
4.
go back to reference Fatoye F, Gebrye T, Odeyemi I. Real-world incidence and prevalence of low back pain using routinely collected data. Rheumatol Int. 2019;39(4):619–26.PubMedCrossRef Fatoye F, Gebrye T, Odeyemi I. Real-world incidence and prevalence of low back pain using routinely collected data. Rheumatol Int. 2019;39(4):619–26.PubMedCrossRef
5.
go back to reference Altinel L, et al. The prevalence of low back pain and risk factors among adult population in Afyon region, Turkey. Acta Orthop Traumatol Turc. 2008;42(5):328–33.PubMedCrossRef Altinel L, et al. The prevalence of low back pain and risk factors among adult population in Afyon region, Turkey. Acta Orthop Traumatol Turc. 2008;42(5):328–33.PubMedCrossRef
6.
7.
go back to reference Smuck M, et al. Does physical activity influence the relationship between low back pain and obesity? Spine J. 2014;14(2):209–16.PubMedCrossRef Smuck M, et al. Does physical activity influence the relationship between low back pain and obesity? Spine J. 2014;14(2):209–16.PubMedCrossRef
8.
go back to reference Yang H, Haldeman S. Behavior-related factors Associated with Low Back Pain in the US Adult Population. Spine (Phila Pa 1976). 2018;43(1):28–34.PubMedCrossRef Yang H, Haldeman S. Behavior-related factors Associated with Low Back Pain in the US Adult Population. Spine (Phila Pa 1976). 2018;43(1):28–34.PubMedCrossRef
9.
go back to reference Kesiena O, et al. Sociodemographic and work-related predictors of chronic lower back pain in the United States: the 2018 National Health interview Survey data. Public Health. 2021;198:30–4.PubMedCrossRef Kesiena O, et al. Sociodemographic and work-related predictors of chronic lower back pain in the United States: the 2018 National Health interview Survey data. Public Health. 2021;198:30–4.PubMedCrossRef
10.
11.
go back to reference Park SM, et al. Depression is closely Associated with Chronic Low Back Pain in patients over 50 years of age: a cross-sectional study using the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-2). Spine (Phila Pa 1976). 2018;43(18):1281–8.PubMedCrossRef Park SM, et al. Depression is closely Associated with Chronic Low Back Pain in patients over 50 years of age: a cross-sectional study using the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-2). Spine (Phila Pa 1976). 2018;43(18):1281–8.PubMedCrossRef
12.
go back to reference Biglarian A, et al. Low back pain prevalence and associated factors in Iranian population: findings from the national health survey. Pain Res Treat. 2012;2012:p653060. Biglarian A, et al. Low back pain prevalence and associated factors in Iranian population: findings from the national health survey. Pain Res Treat. 2012;2012:p653060.
13.
go back to reference Özdemir F, Karaoğlu L, Özfırat Ö. The lifetime and point prevalences of Neck, Upper Back and Low Back Pain of the people living in the Central Malatya with the influencing factors. Agri. 2013;25(1):27–35.PubMedCrossRef Özdemir F, Karaoğlu L, Özfırat Ö. The lifetime and point prevalences of Neck, Upper Back and Low Back Pain of the people living in the Central Malatya with the influencing factors. Agri. 2013;25(1):27–35.PubMedCrossRef
14.
go back to reference Schmidt CO, et al. Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine (Phila Pa 1976). 2007;32(18):2005–11.PubMedCrossRef Schmidt CO, et al. Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine (Phila Pa 1976). 2007;32(18):2005–11.PubMedCrossRef
15.
go back to reference Batista A, Henschke N, Oliveira V. Prevalence of low back pain in different educational levels: a systematic review. Fisioterapia E Movimento. 2017;30:S351–61.CrossRef Batista A, Henschke N, Oliveira V. Prevalence of low back pain in different educational levels: a systematic review. Fisioterapia E Movimento. 2017;30:S351–61.CrossRef
16.
go back to reference Bento TPF, et al. Low back pain and some associated factors: is there any difference between genders? Braz J Phys Ther. 2020;24(1):79–87.PubMedCrossRef Bento TPF, et al. Low back pain and some associated factors: is there any difference between genders? Braz J Phys Ther. 2020;24(1):79–87.PubMedCrossRef
17.
go back to reference Wáng YX, Wáng JQ, Káplár Z. Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review. Quant Imaging Med Surg. 2016;6(2):199–206.PubMedPubMedCentralCrossRef Wáng YX, Wáng JQ, Káplár Z. Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review. Quant Imaging Med Surg. 2016;6(2):199–206.PubMedPubMedCentralCrossRef
18.
go back to reference Palacios-Ceña D, et al. Female gender is Associated with a higher prevalence of chronic Neck Pain, Chronic Low Back Pain, and Migraine: results of the Spanish National Health Survey, 2017. Pain Med. 2020;22(2):382–95.CrossRef Palacios-Ceña D, et al. Female gender is Associated with a higher prevalence of chronic Neck Pain, Chronic Low Back Pain, and Migraine: results of the Spanish National Health Survey, 2017. Pain Med. 2020;22(2):382–95.CrossRef
19.
go back to reference Green BN, et al. Association between Smoking and Back Pain in a cross-section of Adult americans. Cureus. 2016;8(9):e806.PubMedPubMedCentral Green BN, et al. Association between Smoking and Back Pain in a cross-section of Adult americans. Cureus. 2016;8(9):e806.PubMedPubMedCentral
20.
go back to reference Campbell P, Hope K, Dunn KM. The pain, depression, disability pathway in those with low back pain: a moderation analysis of health locus of control. J Pain Res. 2017;10:2331–9.PubMedPubMedCentralCrossRef Campbell P, Hope K, Dunn KM. The pain, depression, disability pathway in those with low back pain: a moderation analysis of health locus of control. J Pain Res. 2017;10:2331–9.PubMedPubMedCentralCrossRef
21.
go back to reference Munce SEP, Stewart DE. Gender differences in Depression and Chronic Pain conditions in a national epidemiologic survey. Psychosomatics. 2007;48(5):394–9.PubMedCrossRef Munce SEP, Stewart DE. Gender differences in Depression and Chronic Pain conditions in a national epidemiologic survey. Psychosomatics. 2007;48(5):394–9.PubMedCrossRef
22.
go back to reference Shors TJ, et al. Do sex differences in rumination explain sex differences in depression? J Neurosci Res. 2017;95(1–2):711–8.PubMedCrossRef Shors TJ, et al. Do sex differences in rumination explain sex differences in depression? J Neurosci Res. 2017;95(1–2):711–8.PubMedCrossRef
23.
go back to reference Nolen-Hoeksema S, Larson J, Grayson C. Explaining the gender difference in depressive symptoms. J Pers Soc Psychol. 1999;77(5):1061–72.PubMedCrossRef Nolen-Hoeksema S, Larson J, Grayson C. Explaining the gender difference in depressive symptoms. J Pers Soc Psychol. 1999;77(5):1061–72.PubMedCrossRef
24.
go back to reference Hyde JS, Mezulis AH. Gender differences in Depression: Biological, Affective, Cognitive, and sociocultural factors. Harv Rev Psychiatry. 2020;28(1):4–13.PubMedCrossRef Hyde JS, Mezulis AH. Gender differences in Depression: Biological, Affective, Cognitive, and sociocultural factors. Harv Rev Psychiatry. 2020;28(1):4–13.PubMedCrossRef
25.
go back to reference Virkkunen T et al. Depressive symptoms are Associated with decreased quality of life and work ability in currently Working Health Care Workers with recurrent low back Pain. J Occup Environ Med, 2022. 64(9). Virkkunen T et al. Depressive symptoms are Associated with decreased quality of life and work ability in currently Working Health Care Workers with recurrent low back Pain. J Occup Environ Med, 2022. 64(9).
26.
go back to reference García-Esquinas E, et al. Gender differences in Pain Risk in Old Age: magnitude and contributors. Mayo Clin Proc. 2019;94(9):1707–17.PubMedCrossRef García-Esquinas E, et al. Gender differences in Pain Risk in Old Age: magnitude and contributors. Mayo Clin Proc. 2019;94(9):1707–17.PubMedCrossRef
27.
go back to reference Oksuz E. Prevalence, risk factors, and preference-based health states of low back pain in a Turkish population. Spine. 2006;31(25):E968–72.PubMedCrossRef Oksuz E. Prevalence, risk factors, and preference-based health states of low back pain in a Turkish population. Spine. 2006;31(25):E968–72.PubMedCrossRef
28.
go back to reference Capkin E, et al. The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey. J Back Musculoskelet Rehabil. 2015;28(4):783–7.PubMedCrossRef Capkin E, et al. The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey. J Back Musculoskelet Rehabil. 2015;28(4):783–7.PubMedCrossRef
29.
go back to reference Sögüt Ç, Eser E. Manisa Şehzadeler Bölgesi’nde Yaşayan Erişkin 18–64 Yaş Arası Kadınlarda Yaşam Boyu Kronik Bel Ağrısı Prevalansı ve Nedenselliği. Sağlık Ve Toplum. 2020;30(2):70–80. Sögüt Ç, Eser E. Manisa Şehzadeler Bölgesi’nde Yaşayan Erişkin 18–64 Yaş Arası Kadınlarda Yaşam Boyu Kronik Bel Ağrısı Prevalansı ve Nedenselliği. Sağlık Ve Toplum. 2020;30(2):70–80.
30.
go back to reference Robertson D, et al. Associations between low back pain and depression and somatization in a Canadian emerging adult population. J Can Chiropr Assoc. 2017;61(2):96–105.PubMedPubMedCentral Robertson D, et al. Associations between low back pain and depression and somatization in a Canadian emerging adult population. J Can Chiropr Assoc. 2017;61(2):96–105.PubMedPubMedCentral
31.
go back to reference Su CA, et al. The Association between Body Mass Index and the prevalence, severity, and frequency of low back Pain: Data from the Osteoarthritis Initiative. Spine (Phila Pa 1976). 2018;43(12):848–52.PubMedCrossRef Su CA, et al. The Association between Body Mass Index and the prevalence, severity, and frequency of low back Pain: Data from the Osteoarthritis Initiative. Spine (Phila Pa 1976). 2018;43(12):848–52.PubMedCrossRef
32.
go back to reference Bae YH, et al. Association between Hypertension and the prevalence of low back Pain and Osteoarthritis in koreans: a cross-sectional study. PLoS ONE. 2015;10(9):e0138790.PubMedPubMedCentralCrossRef Bae YH, et al. Association between Hypertension and the prevalence of low back Pain and Osteoarthritis in koreans: a cross-sectional study. PLoS ONE. 2015;10(9):e0138790.PubMedPubMedCentralCrossRef
33.
go back to reference Hintzpeter B, et al. European health interview survey (EHIS) 2–background and study methodology. J Health Monit. 2019;4(4):66.PubMedPubMedCentral Hintzpeter B, et al. European health interview survey (EHIS) 2–background and study methodology. J Health Monit. 2019;4(4):66.PubMedPubMedCentral
34.
go back to reference EUROSTAT-a, European Health Interview Survey (EHIS). Information on data details relevant for research project proposals. 2012, European Commission, Social Statistics and Information Society.: Luxembourg. EUROSTAT-a, European Health Interview Survey (EHIS). Information on data details relevant for research project proposals. 2012, European Commission, Social Statistics and Information Society.: Luxembourg.
35.
go back to reference Fernández-de-las-Peñas C, et al. Has the prevalence of neck pain and low back pain changed over the last 5 years? A population-based national study in Spain. Spine J. 2013;13(9):1069–76.PubMedCrossRef Fernández-de-las-Peñas C, et al. Has the prevalence of neck pain and low back pain changed over the last 5 years? A population-based national study in Spain. Spine J. 2013;13(9):1069–76.PubMedCrossRef
36.
go back to reference Yang H, et al. Low back pain prevalence and related workplace psychosocial risk factors: a study using data from the 2010 National Health interview survey. J Manip Physiol Ther. 2016;39(7):459–72.CrossRef Yang H, et al. Low back pain prevalence and related workplace psychosocial risk factors: a study using data from the 2010 National Health interview survey. J Manip Physiol Ther. 2016;39(7):459–72.CrossRef
37.
go back to reference Koyanagi A, et al. The association between obesity and back pain in nine countries: a cross-sectional study. BMC Public Health. 2015;15(1):1–9.CrossRef Koyanagi A, et al. The association between obesity and back pain in nine countries: a cross-sectional study. BMC Public Health. 2015;15(1):1–9.CrossRef
38.
go back to reference TSI. Türkiye Sağlık Araştırması Mikro Veri Seti. 2019. TSI. Türkiye Sağlık Araştırması Mikro Veri Seti. 2019.
39.
go back to reference Güleç MY, et al. Psychometric properties of the Turkish version of the patient health questionnaire–somatic, anxiety, and depressive symptoms. Compr Psychiatr. 2012;53(5):623–9.CrossRef Güleç MY, et al. Psychometric properties of the Turkish version of the patient health questionnaire–somatic, anxiety, and depressive symptoms. Compr Psychiatr. 2012;53(5):623–9.CrossRef
40.
go back to reference Kaymaz S et al. Validity and reliability of the Turkish version of the Patient Health Questionnaire-8 for patients with systemic sclerosis. J Turkish Soc Rheumatol, 2021, 13(2). Kaymaz S et al. Validity and reliability of the Turkish version of the Patient Health Questionnaire-8 for patients with systemic sclerosis. J Turkish Soc Rheumatol, 2021, 13(2).
41.
go back to reference Kroenke K, et al. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114(1–3):163–73.PubMedCrossRef Kroenke K, et al. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114(1–3):163–73.PubMedCrossRef
42.
go back to reference Craig CL, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.PubMedCrossRef Craig CL, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.PubMedCrossRef
43.
go back to reference Ekelund U, et al. Criterion-related validity of the last 7-day, short form of the International Physical Activity Questionnaire in Swedish adults. Public Health Nutr. 2006;9(2):258–65.PubMedCrossRef Ekelund U, et al. Criterion-related validity of the last 7-day, short form of the International Physical Activity Questionnaire in Swedish adults. Public Health Nutr. 2006;9(2):258–65.PubMedCrossRef
44.
go back to reference Oh JY, et al. Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. J Korean Acad Family Med. 2007;28(7):532–41. Oh JY, et al. Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. J Korean Acad Family Med. 2007;28(7):532–41.
45.
go back to reference Saglam M, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010;111(1):278–84.PubMedCrossRef Saglam M, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010;111(1):278–84.PubMedCrossRef
46.
go back to reference Cinaroglu S. Risk factors associated with chronic low back pain: an analysis of Turkey health survey data. Int J Community Med Public Health. 2018;5:454.CrossRef Cinaroglu S. Risk factors associated with chronic low back pain: an analysis of Turkey health survey data. Int J Community Med Public Health. 2018;5:454.CrossRef
48.
go back to reference Yung Y-F, Lamm M, Zhang W. Causal mediation analysis with the CAUSALMED procedure. in Proceedings of the SAS Global Forum 2018 Conference. 2018. SAS Institute Inc, Cary, NC. Yung Y-F, Lamm M, Zhang W. Causal mediation analysis with the CAUSALMED procedure. in Proceedings of the SAS Global Forum 2018 Conference. 2018. SAS Institute Inc, Cary, NC.
49.
go back to reference Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40(3):879–91.PubMedCrossRef Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40(3):879–91.PubMedCrossRef
50.
go back to reference Gilgil E, et al. Prevalence of low back pain in a developing urban setting. Spine (Phila Pa 1976). 2005;30(9):1093–8.PubMedCrossRef Gilgil E, et al. Prevalence of low back pain in a developing urban setting. Spine (Phila Pa 1976). 2005;30(9):1093–8.PubMedCrossRef
51.
go back to reference Bejia I, et al. Prevalence and factors associated to low back pain among hospital staff. Joint bone Spine. 2005;72(3):254–9.PubMedCrossRef Bejia I, et al. Prevalence and factors associated to low back pain among hospital staff. Joint bone Spine. 2005;72(3):254–9.PubMedCrossRef
52.
go back to reference Currie SR, Wang J. Chronic back pain and major depression in the general Canadian population. Pain. 2004;107(1–2):54–60.PubMedCrossRef Currie SR, Wang J. Chronic back pain and major depression in the general Canadian population. Pain. 2004;107(1–2):54–60.PubMedCrossRef
53.
go back to reference Taguchi T. Low back pain in young and middle-aged people. Japan Med Association J. 2003;46(10):417–23. Taguchi T. Low back pain in young and middle-aged people. Japan Med Association J. 2003;46(10):417–23.
54.
go back to reference Heuch I, et al. Does the risk of chronic low back pain depend on age at menarche or menopause? A population-based cross-sectional and cohort study: the Trøndelag Health Study. BMJ Open. 2022;12(2):e055118.PubMedPubMedCentralCrossRef Heuch I, et al. Does the risk of chronic low back pain depend on age at menarche or menopause? A population-based cross-sectional and cohort study: the Trøndelag Health Study. BMJ Open. 2022;12(2):e055118.PubMedPubMedCentralCrossRef
55.
go back to reference Aydin G. The status of women in Working Life in Turkey. Social Sci Stud J. 2020;6:292–300. Aydin G. The status of women in Working Life in Turkey. Social Sci Stud J. 2020;6:292–300.
56.
go back to reference Korkmaz A, Korkut G. Determinants of Female Labor Force Participation in Turkey. Suleyman Demirel Univ Fac Econ Administrative Sci J. 2012;17(2):41–65. Korkmaz A, Korkut G. Determinants of Female Labor Force Participation in Turkey. Suleyman Demirel Univ Fac Econ Administrative Sci J. 2012;17(2):41–65.
57.
go back to reference Osinuga A, et al. A meta-analysis of the association between physical demands of domestic labor and back pain among women. BMC Womens Health. 2021;21(1):150.PubMedPubMedCentralCrossRef Osinuga A, et al. A meta-analysis of the association between physical demands of domestic labor and back pain among women. BMC Womens Health. 2021;21(1):150.PubMedPubMedCentralCrossRef
58.
go back to reference Chou YC, et al. Low back pain associated with sociodemographic factors, lifestyle and osteoporosis: a population-based study. J Rehabil Med. 2013;45(1):76–80.PubMedCrossRef Chou YC, et al. Low back pain associated with sociodemographic factors, lifestyle and osteoporosis: a population-based study. J Rehabil Med. 2013;45(1):76–80.PubMedCrossRef
59.
go back to reference Feng C-K, Chen M-L, Mao IF. Prevalence of and risk factors for different measures of low back pain among female nursing aides in Taiwanese nursing homes. BMC Musculoskelet Disord. 2007;8(1):52.PubMedPubMedCentralCrossRef Feng C-K, Chen M-L, Mao IF. Prevalence of and risk factors for different measures of low back pain among female nursing aides in Taiwanese nursing homes. BMC Musculoskelet Disord. 2007;8(1):52.PubMedPubMedCentralCrossRef
60.
go back to reference de Souza IMB, et al. Prevalence of low back pain in the elderly population: a systematic review. Clin (Sao Paulo). 2019;74:e789.CrossRef de Souza IMB, et al. Prevalence of low back pain in the elderly population: a systematic review. Clin (Sao Paulo). 2019;74:e789.CrossRef
61.
go back to reference Uçar D, et al. Ev hanımlarında kronik bel ağrısı. J Clin Experimental Investigations. 2011;2(3):295–8. Uçar D, et al. Ev hanımlarında kronik bel ağrısı. J Clin Experimental Investigations. 2011;2(3):295–8.
62.
go back to reference Atchison JW, Vincent HK. Obesity and low back pain: relationships and treatment. Pain Manage. 2012;2(1):79–86.CrossRef Atchison JW, Vincent HK. Obesity and low back pain: relationships and treatment. Pain Manage. 2012;2(1):79–86.CrossRef
63.
go back to reference Ewald SC, Hurwitz EL, Kizhakkeveettil A. The effect of obesity on treatment outcomes for low back pain. Chiropr Man Th. 2016;24:48.CrossRef Ewald SC, Hurwitz EL, Kizhakkeveettil A. The effect of obesity on treatment outcomes for low back pain. Chiropr Man Th. 2016;24:48.CrossRef
64.
66.
go back to reference Trivedi MH. The link between depression and physical symptoms. Prim Care Companion J Clin Psychiatry. 2004;6(Suppl 1):12–6.PubMedPubMedCentral Trivedi MH. The link between depression and physical symptoms. Prim Care Companion J Clin Psychiatry. 2004;6(Suppl 1):12–6.PubMedPubMedCentral
68.
go back to reference Maria C, Pitharouli MS, et al. Elevated C-Reactive protein in patients with Depression, Independent of Genetic, Health, and psychosocial factors: results from the UK Biobank. Am J Psychiatry. 2021;178(6):522–9.CrossRef Maria C, Pitharouli MS, et al. Elevated C-Reactive protein in patients with Depression, Independent of Genetic, Health, and psychosocial factors: results from the UK Biobank. Am J Psychiatry. 2021;178(6):522–9.CrossRef
Metadata
Title
The mediating role of depressive symptoms among Turkish population related to gender and low back pain: evidence from a national health survey
Authors
Nadire Gülçin Yıldız
Halide Z. Aydin
Grace Sambo
Kemal Aydın
Hatice Yıldız
Ichtiarini Nurullita Santri
Yuniar Wardani
Bwanalori Mwamulima
Khoiriyah Isni
Yohane V. A. Phiri
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18612-9

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