Cognitive-behavioral management training of depressive symptoms among inpatient orthopedic patients with chronic low back pain and depressive symptoms: A 2-year longitudinal study

Article type: Research Article

Authors: Hampel, Petra^{a; *} | Tlach, Lisa^b

Affiliations: [a] Institute of Health, Nutrition, and Sport Sciences, University of Flensburg, Flensburg, Germany | [b] Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Correspondence: [*] Corresponding author: Petra Hampel, Institute of Health, Nutrition, and Sport Sciences, University of Flensburg, Auf dem Campus 1, 24943 Flensburg, Germany. Tel.: +49 461 805 2418; Fax: +49 461 95 805 2418; E-mail: petra.hampel@uni-flensburg.de

Abstract: BACKGROUND AND OBJECTIVES:Co-existing depressive symptoms aggravate the chronic course of pain and may interfere with successful rehabilitation. OBJECTIVE:To examine the psychosocial rehabilitation success of a standard rehabilitation program with a supplemental cognitive-behavioral management training of depressive symptoms compared to the standard rehabilitation alone among patients with chronic low back pain (CLBP) and depressive symptoms. METHODS:Effects on psychological measures (depressive symptoms, anxiety, and somatization) were evaluated prior to, 6, 12, and 24 months after rehabilitation among N=84 consecutively admitted patients with CLBP and depressive symptoms, aged from 34–59 years. Furthermore, self-reported days of sick leave were determined. RESULTS:Favorable effects on depressive symptoms and anxiety persisted up to the 24-month follow-up assessment and incremental effects of the new program on depressive symptoms and anxiety were found at the 6-month follow-up assessment. Days of sick leave were decreased 6 months after rehabilitation and frequencies of clinical levels of psychological symptoms at the 24-month follow-up assessment were attenuated in the intervention group. CONCLUSIONS:The long-term psychological rehabilitation success among patients with CLBP and depressive symptoms was improved by the newly developed program, whose clinical significance was also supported. Thus, significant factors for the further development of CLBP were ameliorated.

Keywords: Chronic low back pain, depressive symptoms, multidisciplinary inpatient orthopedic rehabilitation, cognitive-behavioral management of depressive symptoms, psychosocial outcomes

DOI: 10.3233/BMR-140489

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 49-60, 2015