Relationship between Depression and Coping Strategies in Chronic Back Pain Patients

  Background and Objective: Chronic Back pain is one of the most common pain manifestaion and depression is a prevalent disorder among patient s with chronic pain. However, all of patients with chronic pain do not show the same level of depression. So, investigators often assess biomedical and psychological,variables, in particular pain suppressing strategies, to explain some of the differences in relation between depression and chronic pain. The aims of this study were to: 1)give priority pain suppression strategies in chronic back pain patients, 2) evaluation of suppressing strategies efficacyf in pain control , 3) Assessing the relations between these strategies and depression , and 4) to determine the selective suppressing strategies to predict depression with pain control intensity and pain duration in chronic back pain patient.   Materials and Methods: A total of 185 patients (ages 18-68 yr) with chronic back pain for more than three months, presenting to Under evaluation clinics completed questionnaires of pain intensity scale (NRS), and depression, painsuppressing strategies and demographic ones.   Results: The results showed that the strategy most applied by patients was the praying/hoping , but the most efficient strategies to control pain were ignoring pain sensations and coping self-speech. Catastrophizing was the most unefficient strategy to control pain. The results of correlation analysis with controlling of biomedical variable (pain intensity & pain duration) indicated that the more use of catastrophizing was associated with more depression and,more use of self- speech and diverting attention were associated with less depression.The multivariant stepwise regression revealed that self-speech and catastrophizing were inturn the most strong adaptive and maladaptive predictors of depression, that explained 47% of shared variance of depression results . Also The Beta Coefficient was only significant for these two coping strategies (P≤0.05).   Conclusion: The results of the current study show that adaptive (such as self-speech & diverting attention) and maladaptive (such as catastrophizing) coping strategies are effective in causing depressed mood. These coping strategies are potentially modifiable and could be the target of treatment interventions to decrease depression in chronic back pain patients.