Evaluation of Underlying Factors of Back Pain in Patients with Depression and Psychosis

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Abstract: Back pain is a common complaint in depression, anxiety and somatoform disorders. In this prospective study,
we aimed to evaluate the underlying factors for back pain in patients with depression and psychosis. 129 patients aged
≥18 years with anxiety disorder and somatoform disorder, including 78 patients with back pain and 51 controls without
back pain who presented to our clinic. Visual Analog Score (VAS), tender point count, blood levels of vitamin D,
calcium, phosphor, magnesium, and thyroid stimulating hormone (TSH), and thoracolumbar magnetic resonance imaging
(MRI) were performed in all subjects to evaluate the possible underlying causes of pain. There were significant
differences in weight, VAS score, tender point count, Schmorl’s node, Modic’s degeneration and blood levels of vitamin
D, Ca, P, Mg and TSH between study group and controls. We recommend to perform thoracolumbar MR imaging and to
evaluate blood chemistry for vitamin D deficiency and other osteomalacia risk factors in psychiatric patients presenting
with back pain and to revalue treatment based on results obtained.
Keywords: Low-back pain, depression, psychosis, magnetic resonance imaging, Modic degeneration, endplate
degeneration.

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