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Depression and gender differences among younger immigrant patients on sick leave due to chronic back pain: a primary care study
Karolinska Inst, Ctr Family & Community Med, Dept Neurobiol Caring Sci & Soc, Stockholm, Sweden; Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
2014 (English)In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 15, no 1, 5-14 p.Article in journal (Refereed) Published
Abstract [en]

Background Mental ill-health and pain are major causes for disability compensation in female adults in Sweden.

Aims The aims of this study were to (1) analyse gender differences in the prevalence of depression among immigrant patients with chronic back pain and (2) explore whether factors such as age, marital status, educational level, religious faith, number of children and number of diagnosed pain sites could explain these differences.

Methods The study sample consisted of 245 sick-listed primary care patients in consecutive order aged 18 through 45 years with a median duration of sick leave of 10 months for back pain and participating in a rehabilitation programme. Explanatory variables included physicians’ diagnosed pain sites, age, marital status, education, number of children and religious affiliation. Predictive factors for depression were analysed using logistic regression.

Findings The women differed significantly from the men in three aspects: they were less educated, had more children and had more multiple pain sites, that is, 68% versus 45%. In the age-adjusted model, women were twice as likely to have depression (odds ratio (OR) 2.1). Regardless the gender, those with intermediate education of 9–11 years had the lowest odds of outcome compared with those with <0–8 years and ⩾12 years education. Finally, after adjusting for all explanatory variables, the ORs of depression for women decreased to a non-significant level (OR 1.8; 95% confidence interval (CI) 0.94–3.43). Furthermore, regardless of the gender, those with multiple pain sites had twice higher odds (OR 2.04; 95% CI 1.11–3.74) of depression than those with fewer pain sites.

Conclusion Gender differences in odds of depression in our study could be explained by a higher prevalence of diagnosed multiple pain sites in women. This calls for tailor-made treatments that focus on the pain relief needs of immigrant women with low education and chronic back pain.

Place, publisher, year, edition, pages
2014. Vol. 15, no 1, 5-14 p.
Keyword [en]
chronic back pain, depression, immigrants, primary care, somatic pain
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-189478DOI: 10.1017/S1463423612000564ISI: 000209619400003PubMedID: 23388495OAI: oai:DiVA.org:uu-189478DiVA: diva2:581548
Funder
Stockholm County Council
Available from: 2013-01-02 Created: 2013-01-02 Last updated: 2017-12-06Bibliographically approved

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