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Child and Adolescent Psychiatry and Mental Health
Published in: Child and Adolescent Psychiatry and Mental Health 1/2019

Open Access 01-12-2019 | Back Pain | Research article

The relationship between the psychological stress of adolescents in school and the prevalence of chronic low back pain: a cross-sectional study in China

Authors: Qixiang Mei, Chunlin Li, Yue Yin, Qi Wang, Qiugen Wang, Guoying Deng

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2019

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Abstract

Background

Accumulating evidence supports an association between an unhealthy mental state and low back pain (LBP). However, the degree of the association between mental health and chronic low back pain (CLBP) in the general population is poorly understood. The objective of this study was to analyze the incidence of CLBP in Chinese college students and to examine the association between students’ unhealthy mental states and the prevalence of CLBP.

Methods

This is a cross-sectional study. A total of 10,000 questionnaires were distributed in the second semester of the 2017–2018 academic year by the School of Medicine, Shanghai JiaoTong University. Eligible participants were students aged ≥ 18 years from randomly selected Chinese colleges. Participants completed a questionnaire survey that included items from the Symptom Checklist-90 (SCL-90) and items on demographic factors, LBP prevalence, quality of life at their university, study-related stress and interpersonal relationships. The evaluation of students’ mental states in the survey was divided into two major parts: direct and indirect indicators. A multivariate logistic regression model was mainly used to explore the relationship between CLBP and the students’ mental health.

Results

There was a high incidence of CLBP in the college students. Multiple logistic regression analysis indicated that the risk of CLBP increased with increasing scores on the SCL-90, and a clinically unhealthy mental state (scores greater than 3) was significantly associated with CLBP (adjusted odds ratios for depression, anxiety, coercion, paranoia, and interpersonal sensitivity were 7.209, 6.593, 3.959, 4.465, and 4.283, respectively; p < 0.001). Participants who had poor living habits or uncomfortable campus lives and those who experienced heavy academic pressure also showed a higher positive association with CLBP compared with the full sample.

Conclusions

Unhealthy psychological conditions, which may be attributed to unsatisfying school lives, excessive learning pressure, and uncomfortable interpersonal relationships, represent a risk factor for CLBP in college students.
Appendix
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Literature
1.
Herndon CM, Zoberi KS, Gardner BJ. Common questions about chronic low back pain. Am Fam Physician. 2015;91(10):708–14.PubMed
2.
Hoy DG, Smith E, Cross M, Sanchez-Riera L, Blyth FM, Buchbinder R, et al. Reflecting on the global burden of musculoskeletal conditions: lessons learnt from the global burden of disease 2010 study and the next steps forward. Ann Rheum Dis. 2015;74(1):4–7.PubMedCrossRef
3.
Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028–37.PubMedCrossRef
4.
Roth-Isigkeit A, Thyen U, Stoven H, Schwarzenberger J, Schmucker P. Pain among children and adolescents: restrictions in daily living and triggering factors. Pediatrics. 2005;115(2):e152–62.PubMedCrossRef
5.
6.
Sokratous S, Merkouris A, Middleton N, Karanikola M. The association between stressful life events and depressive symptoms among Cypriot university students: a cross-sectional descriptive correlational study. BMC Public Health. 2013;13:1121.PubMedPubMedCentralCrossRef
7.
Zivin K, Eisenberg D, Gollust SE, Golberstein E. Persistence of mental health problems and needs in a college student population. J Affect Disord. 2009;117(3):180–5.PubMedCrossRef
8.
Darlow B, Stanley J, Dean S, Abbott JH, Garrett S, Mathieson F, et al. The Fear Reduction Exercised Early (FREE) approach to low back pain: study protocol for a randomised controlled trial. Trials. 2017;18(1):484.PubMedPubMedCentralCrossRef
9.
Nordstoga AL, Nilsen TIL, Vasseljen O, Unsgaard-Tondel M, Mork PJ. The influence of multisite pain and psychological comorbidity on prognosis of chronic low back pain: longitudinal data from the Norwegian HUNT Study. BMJ Open. 2017;7(5):e015312.PubMedPubMedCentralCrossRef
10.
Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: cochrane systematic review and meta-analysis. BMJ (Clinical research ed). 2015;350:h444.PubMedCentral
11.
Zhang Y, Deng G, Zhang Z, Zhou Q, Gao X, Di L, et al. A cross sectional study between the prevalence of chronic pain and academic pressure in adolescents in China (Shanghai). BMC Musculoskeletal Disord. 2015;16:219.CrossRef
12.
Zhang J, Zhang X. Chinese college students’ SCL-90 scores and their relations to the college performance. Asian J Psychiatry. 2013;6(2):134–40.CrossRef
13.
Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ (Clinical research ed). 2006;332(7555):1430–4.PubMedCentralCrossRef
14.
Tong F, Lv Q, Li A, Fang L, Luo Z, Feng J, et al. An epidemiological study of the prevalence rate of inflammatory back pain and axial spondyloarthritis in a university in the south of China. Clin Rheumatol. 2018;37:3087–91.PubMedCrossRef
15.
Castillo LG, Schwartz SJ. Introduction to the special issue on college student mental health. J Clin Psychol. 2013;69(4):291–7.PubMedCrossRef
16.
Kovess-Masfety V, Leray E, Denis L, Husky M, Pitrou I, Bodeau-Livinec F. Mental health of college students and their non-college-attending peers: results from a large French cross-sectional survey. BMC Psychol. 2016;4:20.PubMedPubMedCentralCrossRef
17.
Iacovides S, Avidon I, Baker FC. What we know about primary dysmenorrhea today: a critical review. Hum Reprod Update. 2015;21(6):762–78.PubMedCrossRef
18.
Bjorck-van Dijken C, Fjellman-Wiklund A, Hildingsson C. Low back pain, lifestyle factors and physical activity: a population based-study. J Rehabil Med. 2008;40(10):864–9.PubMedCrossRef
19.
Lacourt TE, Houtveen JH, van Zanten JJ, Bosch JA, Drayson MT, Van Doornen LJ. Negative affectivity predicts decreased pain tolerance during low-grade inflammation in healthy women. Brain Behav Immun. 2015;44:32–6.PubMedCrossRef
20.
Miranda H, Viikari-Juntura E, Punnett L, Riihimaki H. Occupational loading, health behavior and sleep disturbance as predictors of low-back pain. Scand J Work Environ Health. 2008;34(6):411–9.PubMedCrossRef
21.
Park SM, Kim HJ, Jeong H, Kim H, Chang BS, Lee CK, et al. Longer sitting time and low physical activity are closely associated with chronic low back pain in population over 50 years of age: a cross-sectional study using the sixth Korea National Health and Nutrition Examination Survey. Spine J. 2018;18:2051–8.PubMedCrossRef
22.
Zijlema WL, Stolk RP, Lowe B, Rief W, White PD, Rosmalen JG. How to assess common somatic symptoms in large-scale studies: a systematic review of questionnaires. J Psychosom Res. 2013;74(6):459–68.PubMedCrossRef
23.
Yu Y, Wan C, Huebner ES, Zhao X, Zeng W, Shang L. Psychometric properties of the symptom check list 90 (SCL-90) for Chinese undergraduate students. J Ment Health (Abingdon, England). 2019;28(2):213–9.CrossRef
24.
Fernandez-de-las-Penas C, Hernandez-Barrera V, Alonso-Blanco C, Palacios-Cena D, Carrasco-Garrido P, Jimenez-Sanchez S, et al. Prevalence of neck and low back pain in community-dwelling adults in Spain: a population-based national study. Spine. 2011;36(3):E213–9.PubMedCrossRef
25.
Tang NK, Salkovskis PM, Hodges A, Wright KJ, Hanna M, Hester J. Effects of mood on pain responses and pain tolerance: an experimental study in chronic back pain patients. Pain. 2008;138(2):392–401.PubMedCrossRef
26.
Benedetti F, Amanzio M. Mechanisms of the placebo response. Pulm Pharmacol Ther. 2013;26(5):520–3.PubMedCrossRef
27.
Koepp MJ, Hammers A, Lawrence AD, Asselin MC, Grasby PM, Bench CJ. Evidence for endogenous opioid release in the amygdala during positive emotion. NeuroImage. 2009;44(1):252–6.PubMedCrossRef
28.
Wenze SJ, Gunthert KC, German RE. Biases in affective forecasting and recall in individuals with depression and anxiety symptoms. Pers Soc Psychol Bull. 2012;38(7):895–906.PubMedCrossRef
29.
Cannella DT, Lobel M, Glass P, Lokshina I, Graham JE. Factors associated with depressed mood in chronic pain patients: the role of intrapersonal coping resources. J Pain. 2007;8(3):256–62.PubMedCrossRef
30.
Fujii T, Oka H, Katsuhira J, Tonosu J, Kasahara S, Tanaka S, et al. Association between somatic symptom burden and health-related quality of life in people with chronic low back pain. PLoS ONE. 2018;13(2):e0193208.PubMedPubMedCentralCrossRef
31.
Shiri R, Falah-Hassani K, Heliovaara M, Solovieva S, Amiri S, Lallukka T, et al. Risk factors for low back pain: a population-based longitudinal study. Arthritis Care Res. 2018;71:290–9.CrossRef
32.
33.
Gaultney JF. The prevalence of sleep disorders in college students: impact on academic performance. J Am Coll Health. 2010;59(2):91–7.PubMedCrossRef
34.
35.
Gerhart JI, Burns JW, Post KM, Smith DA, Porter LS, Burgess HJ, et al. Relationships between sleep quality and pain-related factors for people with chronic low back pain: tests of reciprocal and time of day effects. Ann Behav Med. 2017;51(3):365–75.PubMedPubMedCentralCrossRef
36.
Bahouq H, Allali F, Rkain H, Hmamouchi I, Hajjaj-Hassouni N. Prevalence and severity of insomnia in chronic low back pain patients. Rheumatol Int. 2013;33(5):1277–81.PubMedCrossRef
37.
Hiyama A, Katoh H, Sakai D, Tanaka M, Sato M, Watanabe M. Clinical impact of JOABPEQ mental health scores in patients with low back pain: analysis using the neuropathic pain screening tool painDETECT. J Orthopaedic Sci. 2017;22(6):1009–14.CrossRef
38.
39.
Imagama S, Hasegawa Y, Wakao N, Hirano K, Muramoto A, Ishiguro N. Impact of spinal alignment and back muscle strength on shoulder range of motion in middle-aged and elderly people in a prospective cohort study. Eur Spine J. 2014;23(7):1414–9.PubMedCrossRef
40.
Korovessis P, Koureas G, Papazisis Z. Correlation between backpack weight and way of carrying, sagittal and frontal spinal curvatures, athletic activity, and dorsal and low back pain in schoolchildren and adolescents. J Spinal Disord Techn. 2004;17(1):33–40.CrossRef
41.
Metadata
Title
The relationship between the psychological stress of adolescents in school and the prevalence of chronic low back pain: a cross-sectional study in China
Authors
Qixiang Mei
Chunlin Li
Yue Yin
Qi Wang
Qiugen Wang
Guoying Deng
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2019
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-019-0283-2

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