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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2000 Nov 1;91(6):459–464. doi: 10.1007/BF03404830

The Saskatchewan Health and Back Pain Survey: The Prevalence and Factors Associated with Depressive Symptomatology in Saskatchewan Adults

Linda J Carroll 114,✉, J David Cassidy 114, Pierre Côté 214,314
PMCID: PMC6980023  PMID: 11200740

Abstract

Objectives: To determine the one-week period prevalence of depressive symptomatology among Saskatchewan adults and to identify sociodemographic and health factors associated with depressive symptomatology.

Methods: The Saskatchewan Health and Back Pain Survey was mailed to an age-stratified random sample of adults. Of the 2,184 eligible subjects, 55% (n=1131) responded to the survey. We report age-standardized prevalence estimates stratified by age, gender and spinal pain severity. Logistic regression was used to measure the presence and strength of association between various factors and depressive symptomatology.

Results: 22.2% (95% CI 19.6–24.9) of adults experienced depressive symptomatology during the previous week, with higher rates in younger adults, in females, and in those with disabling spinal pain. Depressive symptomatology was associated with age, income, smoking, health status, gastro-intestinal problems, headaches and spinal pain.

Conclusions: Depressive symptomatology is common in the Saskatchewan adult population, and is related to age, pain severity and general health.

Footnotes

This research was funded by a grant from the Chiropractors’ Association of Saskatchewan.

References

  • 1.Johnson J, Weissman MM, Klerman GL. Service utilization and social morbidity associated with depressive symptoms in the community. JAMA. 1992;267:1478–83. doi: 10.1001/jama.1992.03480110054033. [DOI] [PubMed] [Google Scholar]
  • 2.Crum RM, Cooper-Patrick L, Ford DE. Psychosomatic Medicine. 1994;56:109–17. doi: 10.1097/00006842-199403000-00006. [DOI] [PubMed] [Google Scholar]
  • 3.Horwath E, Johnson J, Klerman GL, Weissman MM. Depressive symptoms as relative and attributable risk factors for first-onset major depression. Arch Gen Psychiatry. 1992;49:817–23. doi: 10.1001/archpsyc.1992.01820100061011. [DOI] [PubMed] [Google Scholar]
  • 4.Wells KB, Burnam MA, Rogers W, et al. The course of depression in adult outpatients. Results from the Medical Outcomes Study. Arch Gen Psychiatry. 1992;49:788–94. doi: 10.1001/archpsyc.1992.01820100032007. [DOI] [PubMed] [Google Scholar]
  • 5.Broadhead WE, Blazer DG, George LK, Tse CK. Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA. 1990;264:2524–28. doi: 10.1001/jama.1990.03450190056028. [DOI] [PubMed] [Google Scholar]
  • 6.Frombonne E. Increased rates of depression: Update of epidemiological findings and analytical problems. Acta Psychiatrica Scandinavica. 1994;90:145–56. doi: 10.1111/j.1600-0447.1994.tb01571.x. [DOI] [PubMed] [Google Scholar]
  • 7.Henderson JG, Pollard CA. Prevalence of various depressive symptoms in a sample of the general population. Psychological Reports. 1992;71:208–10. doi: 10.2466/pr0.1992.71.1.208. [DOI] [PubMed] [Google Scholar]
  • 8.Regier DA, Boyd JH, Burke JD, et al. Onemonth prevalence of mental disorders in the United States. Based on five epidemiologic catchment areas. Arch Gen Psychiatry. 1988;45:977–86. doi: 10.1001/archpsyc.1988.01800350011002. [DOI] [PubMed] [Google Scholar]
  • 9.Robins LN, Helzer JE, Weissman MM, et al. Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry. 1984;41:949–58. doi: 10.1001/archpsyc.1984.01790210031005. [DOI] [PubMed] [Google Scholar]
  • 10.Culbertson FM. Depression and gender: An international review. American Psychologist. 1997;52:25–31. doi: 10.1037/0003-066X.52.1.25. [DOI] [PubMed] [Google Scholar]
  • 11.Gatz M, Johansson B, Pedersen N, et al. A crossnational self-report measure of depressive symptomatology. International Psychogeriatrics. 1993;5:147–56. doi: 10.1017/S1041610293001486. [DOI] [PubMed] [Google Scholar]
  • 12.Kessler RC, Foster C, Webster PS, House JS. The relationship between age and depressive symptoms in two national surveys. Psychology and Aging. 1992;7:119–26. doi: 10.1037/0882-7974.7.1.119. [DOI] [PubMed] [Google Scholar]
  • 13.France RD, Houpt JL, Skott A, et al. Depression as a psychopathological disorder in chronic low back pain patients. J Psychosomatic Research. 1986;30:127–33. doi: 10.1016/0022-3999(86)90041-3. [DOI] [PubMed] [Google Scholar]
  • 14.Herr KA, Mobily PR, Smith C. Depression and the experience of chronic back pain: A study of related variables and age differences. Clin J Pain. 1993;9:104–14. doi: 10.1097/00002508-199306000-00005. [DOI] [PubMed] [Google Scholar]
  • 15.Love AW. Depression in chronic low back pain patients: Diagnostic efficiency of three self-report questionnaires. J Clin Psychol. 1987;43:84–89. [PubMed] [Google Scholar]
  • 16.Magni G, Marchetti M, Moreschi C, et al. Chronic musculoskeletal pain and depressive symptoms in the National Health and Nutrition Examination. I. Epidemiologic Follow-up Study. Pain. 1993;43:299–307. doi: 10.1016/0304-3959(90)90027-B. [DOI] [PubMed] [Google Scholar]
  • 17.Rajala U, Keinänen-Kiukaanniemi S, Uusimäki A, Kivelä SL. Musculoskeletal pains and depression in a middle-aged Finnish population. Pain. 1995;61:451–57. doi: 10.1016/0304-3959(94)00206-T. [DOI] [PubMed] [Google Scholar]
  • 18.Sullivan MJL, D’Eon J. Relation between catastrophizing and depression in chronic pain patients. J Abnormal Psychology. 1990;99:260–63. doi: 10.1037/0021-843X.99.3.260. [DOI] [PubMed] [Google Scholar]
  • 19.Turner JA, Romano JM. Self-report screening measures for depression in chronic pain patients. J Clin Psychol. 1984;40:909–13. doi: 10.1002/1097-4679(198407)40:4<909::AID-JCLP2270400407>3.0.CO;2-J. [DOI] [PubMed] [Google Scholar]
  • 20.von Korff M, Dworkin SF, Le Resche L. Graded chronic pain status: An epidemiologic evaluation. Pain. 1990;40:279–91. doi: 10.1016/0304-3959(90)91125-3. [DOI] [PubMed] [Google Scholar]
  • 21.von Korff M, Ormel J, Keefe FJ, Dworkin SF. Grading the severity of chronic pain. Pain. 1992;50:133–49. doi: 10.1016/0304-3959(92)90154-4. [DOI] [PubMed] [Google Scholar]
  • 22.Côté P, Cassidy JD, Carroll LC. The Saskatchewan Health and Back Pain Survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine. 1998;23:1689–98. doi: 10.1097/00007632-199808010-00015. [DOI] [PubMed] [Google Scholar]
  • 23.Radloff LS T C-D scale. A self-reported depression scale for research in the general population. Appl Psychol Measurement. 1977;1:385–401. doi: 10.1177/014662167700100306. [DOI] [Google Scholar]
  • 24.Orme JG, Reis J, Herz EJ. Factorial and discriminant validity of the Center for Epidemiological Studies Depression (CES-D) Scale. J Clin Psychol. 1986;42:28–33. doi: 10.1002/1097-4679(198601)42:1<28::AID-JCLP2270420104>3.0.CO;2-T. [DOI] [PubMed] [Google Scholar]
  • 25.Devins GM, Orme CM, Costello CG, et al. Measuring depressive symptoms in illness populations: Psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) Scale. Psychology and Health. 1988;2:139–56. doi: 10.1080/08870448808400349. [DOI] [Google Scholar]
  • 26.Weissman MM, Sholomskas D, Pottenger M, et al. Assessing depressive symptoms in five psychiatric populations: A validation study. Am J Epidemiol. 1977;106:203–14. doi: 10.1093/oxfordjournals.aje.a112455. [DOI] [PubMed] [Google Scholar]
  • 27.Blalock SJ, DeVellis RF, Brown GK, Wallston KA. Validity of the Center for Epidemiological Studies Depression Scale in arthritis populations. Arthritis and Rheumatism. 1989;32:991–97. doi: 10.1002/anr.1780320808. [DOI] [PubMed] [Google Scholar]
  • 28.Turk DC, Okifuji A. Detecting depression in chronic pain patients: Adequacy of self-reports. Behavior Research and Therapy. 1994;32:9–16. doi: 10.1016/0005-7967(94)90078-7. [DOI] [PubMed] [Google Scholar]
  • 29.Boyd JH, Weissman MM, Thompson WD, Myers JK. Screening for depression in a community sample. Arch Gen Psychiatry. 1982;39:1195–200. doi: 10.1001/archpsyc.1982.04290100059010. [DOI] [PubMed] [Google Scholar]
  • 30.Schulberg HC, Saul M, McClellant M, et al. Assessing depression in primary medical and psychiatric practices. Arch Gen Psychiatry. 1985;42:1164–70. doi: 10.1001/archpsyc.1985.01790350038008. [DOI] [PubMed] [Google Scholar]
  • 31.von Korff M, Dworkin SF, Le Resche L, Kruger A. An epidemiologic comparison of pain complaints. Pain. 1988;32:173–83. doi: 10.1016/0304-3959(88)90066-8. [DOI] [PubMed] [Google Scholar]
  • 32.von Korff M, Le Resche L, Dworkin SF. First onset of common pain symptoms: A prospective study of depression as a risk factor. Pain. 1993;55:251–58. doi: 10.1016/0304-3959(93)90154-H. [DOI] [PubMed] [Google Scholar]
  • 33.von Korff M, Deyo RA, Cherkin D, Barlow W. Back pain in primary care. Outcomes at one year. Spine. 1993;18:855–62. doi: 10.1097/00007632-199306000-00008. [DOI] [PubMed] [Google Scholar]
  • 34.Cassidy JD, Carroll LC, Côté P. The Saskatchewan Health and Back Pain Survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine. 1998;23:1860–67. doi: 10.1097/00007632-199809010-00012. [DOI] [PubMed] [Google Scholar]
  • 35.Ware JE, Snow KK, Kosinski M, Gandek B. Sf-36 Health Survey: Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center; 1993. [Google Scholar]
  • 36.Brazier JE, Harper R, Jones NMB, et al. Validating the SF-36 Health Survey questionnaire: New outcome measure for primary care. Br Med J. 1992;305:160–64. doi: 10.1136/bmj.305.6846.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 37.Garratt AM, Ruta DA, Abdalla MI, et al. The SF-36 health survey questionnaire: An outcome measure suitable for routine use within the NHS? Br Med J. 1993;306:1440–44. doi: 10.1136/bmj.306.6890.1440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Kurtin PS, Davie AR, Meyer KB, et al. Patientbased health status measures in outpatient dialysis: Early experiences in developing an outcomes assessment program. Medical Care. 1992;30(Suppl):MS136–MS149. doi: 10.1097/00005650-199205001-00012. [DOI] [PubMed] [Google Scholar]
  • 39.McHorney CA, Ware JE, Rogers W, et al. The validity and relative precision of MOS Short- and Long-Form Health Status Scales and Dartmouth COOP Charts. Medical Care. 1992;30:253–65. doi: 10.1097/00005650-199205001-00025. [DOI] [PubMed] [Google Scholar]
  • 40.Katz JN, Larson MG, Phillips CB, et al. Comparative measurement sensitivity of short and longer health status instruments. Medical Care. 1992;30:917–25. doi: 10.1097/00005650-199210000-00004. [DOI] [PubMed] [Google Scholar]
  • 41.Kravitz RL, Greenfield S, Rogers WH, et al. Differences in the mix of patients among medical specialities and systems of care: Results from the Medical Outcomes Study. JAMA. 1992;267:1617–23. doi: 10.1001/jama.1992.03480120055033. [DOI] [PubMed] [Google Scholar]
  • 42.Jenkinson C, Coulter A, Wright L. Short-form 36 (SF-36) Health Survey Questionnaire: Normative data for adults of working age. BMJ. 1993;306:1437–40. doi: 10.1136/bmj.306.6890.1437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Fryback DG, Dasbach EJ, Klein R, et al. The Beaver Dam health outcomes study: Initial catalog of health state quality factors. Medical Decision Making. 1993;13:89–102. doi: 10.1177/0272989X9301300202. [DOI] [PubMed] [Google Scholar]
  • 44.Jaroszynski G, Cassidy JD, Carroll L, et al. Development and validation of a comorbidity scale; 1996. [Google Scholar]
  • 45.Tennant A, Badley EM. A confidence interval approach to investigating nonresponse bias and monitoring response to postal questionnaires. J Epidemiol Community Health. 1991;47:15–29. doi: 10.1136/jech.45.1.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46.SPSS for Windows . Version 7.5. IL: SPSS Inc.; 1997. [Google Scholar]
  • 47.Stata 5. College Station. Texas: Stata Corporation; 1997. [Google Scholar]
  • 48.Roberts RE, Vernon SW. The Center for Epidemiologic Studies Depression Scale: Its use in a community sample. Am J Psychiatry. 1983;140:41–46. doi: 10.1176/ajp.140.1.41. [DOI] [PubMed] [Google Scholar]
  • 49.Husaini BA, Neff JA, Stone RH. Psychiatric impairment in rural communities. J Community Psychology. 1979;7:137–46. doi: 10.1002/1520-6629(197904)7:2<137::AID-JCOP2290070207>3.0.CO;2-Q. [DOI] [PubMed] [Google Scholar]
  • 50.Boyd JH, Weissman MM. Epidemiology of affective disorders. A reexamination and future directions. Arch Gen Psychiatry. 1981;38:1039–46. doi: 10.1001/archpsyc.1981.01780340091011. [DOI] [PubMed] [Google Scholar]
  • 51.Weissman MM, Bland R, Joyce PR, et al. Sex differences in rates of depression: Cross-national perspectives. J Affect Disord. 1993;29:77–84. doi: 10.1016/0165-0327(93)90025-F. [DOI] [PubMed] [Google Scholar]
  • 52.Kessler RC, McGonagle KA, Swartz M, et al. Sex and depression in the National Comorbidity Survey I: Lifetime prevalence, chronicity and recurrence. J Affect Disord. 1993;29:85–96. doi: 10.1016/0165-0327(93)90026-G. [DOI] [PubMed] [Google Scholar]
  • 53.Mirowsky J, Ross CE. Age and depression. J Health Soc Behav. 1992;33:187–205. doi: 10.2307/2137349. [DOI] [PubMed] [Google Scholar]
  • 54.Gatz M, Hurwica M-L. Are old people more depressed? Cross-sectional data on Center for Epidemiological Studies Depression Scale factors. Psychology and Aging. 1990;5:284–90. doi: 10.1037/0882-7974.5.2.284. [DOI] [PubMed] [Google Scholar]
  • 55.Coulehan JL, Schulbert HC, Block MR, et al. Medical comorbidity of major depressive disorder in a primary medical practice. Arch Intern Med. 1990;150:2362–67. doi: 10.1001/archinte.1990.00390220099020. [DOI] [PubMed] [Google Scholar]
  • 56.Keitner GI, Ryan C, Miller IW, Normal WH. Recovery and major depression. Am J Psychiatry. 1992;149:93–99. doi: 10.1176/ajp.149.8.1128. [DOI] [PubMed] [Google Scholar]
  • 57.Atkinson JH, Ingram RE, Kremer EF, Saccuszo DP. MMPI subgroups and affective disorder in chronic pain patients. J Nerv Ment Dis. 1986;174:408–13. doi: 10.1097/00005053-198607000-00004. [DOI] [PubMed] [Google Scholar]
  • 58.Dworking RH, Gitlin MJ. Clinical aspects of depression in chronic pain patients. Clin J Pain. 1991;7:79–94. doi: 10.1097/00002508-199106000-00004. [DOI] [PubMed] [Google Scholar]
  • 59.Painter JR, Seres JL, Newman RI. Assessing benefits of pain centers: Why some patients regress. Pain. 1980;8:101–13. doi: 10.1016/0304-3959(80)90093-7. [DOI] [PubMed] [Google Scholar]
  • 60.Kerns RD, Haythornthwaite JA. Depression among chronic pain patients: Cognitivebehavioral analysis and effect on rehabilitation outcome. J Consult Clin Psychol. 1988;56:870–76. doi: 10.1037/0022-006X.56.6.870. [DOI] [PubMed] [Google Scholar]
  • 61.Forrest AJ, Wolkind SN. Masked depression in men with low back pain. Rheum Rehabil. 1974;13:148–53. doi: 10.1093/rheumatology/13.3.148. [DOI] [PubMed] [Google Scholar]
  • 62.Dolce JJ, Crocker MJ, Doleys DM. Predicting outcome among chronic pain patients. Behav Res Ther. 1986;24:313–19. doi: 10.1016/0005-7967(86)90191-9. [DOI] [PubMed] [Google Scholar]
  • 63.Glass R, Allan A, Uhlenhuth M, et al. Psychiatric screening in a medical clinic. Arch Gen Psychiatry. 1978;35:1189–95. doi: 10.1001/archpsyc.1978.01770340039003. [DOI] [PubMed] [Google Scholar]
  • 64.Nelsen A, Williams T. Depression in ambulatory medical patients; prevalence by self-report questionnaire and recognition by non-psychiatric physicians. Arch Gen Psychiatry. 1980;37:999–1004. doi: 10.1001/archpsyc.1980.01780220037003. [DOI] [PubMed] [Google Scholar]
  • 65.Zung W, Magill M, Moore J, George D. Recognition and treatment of depression in a family medicine practice. J Clin Psychiatry. 1983;33:3–6. [PubMed] [Google Scholar]
  • 66.von Korff M, Shapiro S, Burke J, et al. Anxiety and depression in a primary care clinic. Arch Gen Psychiatry. 1987;44:152–56. doi: 10.1001/archpsyc.1987.01800140058008. [DOI] [PubMed] [Google Scholar]
  • 67.Prestidge B, Lake C. Prevalence and recognition of depression among primary care outpatients. J Fam Pract. 1987;25:67–72. [PubMed] [Google Scholar]
  • 68.Barrett JE, Barrett JA, Oxman T, Gerber P. The prevalence of psychiatric disorders in a primary care practice. Arch Gen Psychiatry. 1988;45:1100–106. doi: 10.1001/archpsyc.1988.01800360048007. [DOI] [PubMed] [Google Scholar]
  • 69.Wells KB, Hays RD, Burman MA, et al. Detection of depressive disorder for patients receiving prepaid fee-for-service care: Results from the Medical Outcomes Study. JAMA. 1989;262:3298–302. doi: 10.1001/jama.1989.03430230083030. [DOI] [PubMed] [Google Scholar]
  • 70.Coulehan JL, Schulbert HC, Block MR, et al. Medical comorbidity of major depressive disorder in a primary care medical practice. Arch Intern Med. 1990;150:2362–67. doi: 10.1001/archinte.1990.00390220099020. [DOI] [PubMed] [Google Scholar]
  • 71.Zung WWK, Broadhead WE, Roth ME. Prevalence of depressive symptoms in primary care. J Family Practice. 1993;37:337–44. [PubMed] [Google Scholar]
  • 72.Lehtinen V, Joukamma M. Epidemiology of depression: Prevalence, risk factors and treatment situation. Acta Psychiatr Scand. 1994;377:7–10. doi: 10.1111/j.1600-0447.1994.tb05794.x. [DOI] [PubMed] [Google Scholar]
  • 73.Simon GE, von Korff M. Recognition, management and outcomes of depression in primary care. Arch Fam Med. 1995;4:99–105. doi: 10.1001/archfami.4.2.99. [DOI] [PubMed] [Google Scholar]
  • 74.Angst J, Merikangas K. The depressive spectrum: Diagnostic classification and course. J Affect Disord. 1997;45:31–40. doi: 10.1016/S0165-0327(97)00057-8. [DOI] [PubMed] [Google Scholar]

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