Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20240023-en
Brazilian Journal of Pain
Review Article

Association between low back pain and common mental disorders in adults: systematic review

Associação entre dor lombar e transtornos mentais comuns em adultos: revisão sistemática

Tatiana Gobbi Mendes de Castro; Eduardo de Paula Lima; Alina Gomide Vasconcelos; Elizabeth do Nascimento

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Abstract

BACKGROUND AND OBJECTIVES: Low back pain (LBP) is one of the leading causes of disability worldwide. Its etiology is multifactorial and results in losses for individuals and society. The biopsychosocial model of LBP offers a comprehensive approach to assessment and interventions. Researchers investigate the relationship between LBP and Common Mental Disorders (CMD) within this concept. This systematic review aimed to identify and analyze recent studies on the topic.

CONTENTS: The study was submitted to the International Prospective Register of Systematic Reviews (registration number CRD 42020210375). The 27 articles in the corpus were selected from the Medlin/PubMed and BVS (Biblioteca Virtual em Saúde) databases from 2015 to 2022. Only those that investigated a possible relationship between CMD (anxiety or depression) and LBP in adult populations were included. Most articles in the corpus confirmed the relationship between LBP and CMD, however, gaps were identified regarding the direction of causality between the two outcomes and why this relationship was established. Methodological limitations in relation to sample selection and LBP assessment instruments used were also identified.

CONCLUSION: This review highlights the need for studies on the topic with greater methodological criteria and with a design that allows causality to be assessed. Thus, it will be possible to guide clinical practice based on scientific evidence. Longitudinal studies with an emphasis on the biopsychosocial model can contribute to support specific therapeutic approaches.

Keywords

Anxiety; Common mental disorders; Depression; Low back pain

Resumo

JUSTIFICATIVA E OBJETIVOS:  A dor lombar (DL) é uma das principais causas mundiais de incapacidade. Trata-se de um desfecho cuja etiologia é reconhecidamente multifatorial, com prejuízos para os indivíduos e a sociedade. O modelo biopsicos-social da DL apresenta uma abordagem ampla, tanto na avaliação quanto nas intervenções. A relação entre DL e Transtorno Mental Comum (TMC) é objeto de estudo dentro da concepção desse modelo. O presente estudo teve como objetivo identificar e analisar os estudos recentes sobre esse tema.

CONTEÚDO:  O estudo foi submetido ao International Prospective Register of Systematic Reviews (número de registro CRD 42020210375). Os 27 artigos do corpus foram selecionados das bases de dados Medline/Pubmed e BVS (Biblioteca Virtual em Saúde) no período de 2015 a 2022. Foram incluídos apenas aqueles que investigaram possíveis relações entre TMC (ansiedade ou depressão) e DL em populações adultas. A maioria dos artigos do corpus confirmou a relação entre DL e TMC, no entanto foram identificadas lacunas sobre a direção de causalidade entre os dois desfechos e sobre os motivos pelos quais essa relação se estabeleceu. Também foram identificadas limitações metodológicas em relação à seleção da amostra e aos instrumentos de avaliação da dor lombar utilizados.

CONCLUSÃO:  Esta revisão destacou a necessidade de estudos sobre o tópico com maiores critérios metodológicos e com um desenho que permita avaliar a causalidade. Assim, será possível orientar a prática clínica baseando-se em evidências científicas. Estudos longitudinais com ênfase no modelo biopsicossocial podem contribuir para embasar abordagens terapêuticas específicas.

Palavras-chave

Ansiedade; Depressão; Dor lombar; Transtorno mental comum

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Submitted date:
09/10/2023

Accepted date:
03/14/2024

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