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Durcudoy-Pérez L.1, Mena-Iturriaga M.J.1, Wainer-Baracatt M.P.1, Leppe J.1, Sizer P.S.2, Mauri-Stecca M.V.1
1Universidad del Desarrollo, School of Physical Therapy, Santiago, Chile, 2Texas Tech University Health Sciences Center, Center for Rehabilitation Research, School of Health Professions, Lubbock, United States
Background: Chronic pain and depression have been reported as interrelated variables. According to the 2009-10 Chilean National Health Survey (NHS), the prevalence of chronic musculoskeletal symptoms (MSS) and depressive symptoms (DS) are higher in women and populations with low educational level, representing the main causes of absenteeism in the workplace in Chile.
Purpose: Identifying the relationship between these health conditions would broaden the vision of chronic MSS physiotherapy management. The aim of this study was to determine the relationship between the presence of chronic MSS and DS reported in the 2009-10 Chilean NHS and its distribution regarding social-demographic variables.
Methods: A secondary analysis study from the 2009-10 Chilean NHS was conducted in 2016. The chronic MSS variable was created considering those subjects with more than 12 weeks of MSS. The DS variable was measured through the Short Form of the Composite International Diagnostic Interview (CIDI-SF) instrument. Expansion factors based on the NHS guidelines for analysis were used to calculate the prevalence with a 95%CI of chronic MSS and DS. A simple logistic regression model determined the relationship between MSS and DS, and a multivariate model adjusted data by sociodemographic variables. All statistical analyses were conducted using STATA13.0 software.
Results: A sample of 5,293 subjects responded the NHS. In Chile, at the population level, Chronic MSS was reported in 42% (95%CI 39.9-44.7), DS was reported in 17% (95%CI 15.4-19.1) and both were reported in 10.9% (95%CI 9.4-12.5). From those with chronic MSS, a 63.1% (95%CI 57.2-68.7) also reported the presence of DS. Prevalence distributions based on sex, age, and educational level of those subjects who reported chronic MSS and DS were: (1) 63.4% (95%CI 56.8-69.6) and 62.1% (95%CI 48.9-73.7) of women and men, respectively; (2) 39.1% (95%CI 27.0-52.7) for 15-24 years, 55.3% (95%CI 45.2-65.0) for 25-44 years, 84.4% (95%CI 77.4-89.5) for 45-64 years and 76.5% (95%CI=60.5-87.4) for those more than 64 years; and (3) 83% (95%CI 75.2-88.8) for low-, 63.1% (95%CI 55.3-70.2) for medium-, and 36.8% (95%CI 24.8-50.8) for high-educational levels. Based on a univariate model for DS reported in subjects with chronic MSS, the Odd Ratiocrude was 2.80 (95%CI 2.14-3.68). Adjusted by sex, age, and educational level for DS in subjects with chronic MSS, the Odd Ratioadjust was 2.54 (95%CI 1.91-3.39). For high educational level, the OR was 0.59
(95%CI 0.41-0.84). Other control variables showed OR>1 with p value 0.05.
Conclusion(s): For the country of Chile, the proportion of DS in subjects with chronic MSS is high. Depression symptoms in chronic MSS is higher in low educational levels and active working population. The relationship between chronic MSS and DS is high and independent from other socio-demographic control variables.
Implications: The probability of treating a patient with chronic MSS associated with DS in primary care is high. Therefore, it is important to maintain a multidisciplinary and biopsychosocial approach during the rehabilitation process. Future studies regarding the causes and management of these conditions are suggested in order to improve physical therapy interventions and education.
Funding acknowledgements: Not applicable.
Topic: Musculoskeletal
Ethics approval: Not applicable, since the secondary database is available by the Ministry of Health for research purposes.
All authors, affiliations and abstracts have been published as submitted.
