ArticleSpine2014
Are 2 questions enough to screen for depression and anxiety in patients with chronic low back pain?
Article in Spine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A) for detecting anxiety disorders in adults.The Cochrane database of systematic reviews · 2025Pooled it
- Effectiveness of Briefer Coping-Focused Psychotherapy for Common Mental Complaints on Work-Participation and Mental Health: A Pragmatic Randomized Trial with 2-Year Follow-Up.Journal of occupational rehabilitation · 2020Trial
- Can group-based reassuring information alter low back pain behavior? A cluster-randomized controlled trial.PloS one · 2017Trial
- "It's an Uncomfortable Subject"-a Qualitative Exploration of the Challenges and Potential Solutions to Depression Screening in Low Back Pain.Physical therapy · 2026Article
- Screening for depression, anxiety, and psychological distress associated with low back pain by musculoskeletal and spinal clinicians. A scoping review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Development and external validation of a prediction model for patient-relevant outcomes in patients with chronic widespread pain and fibromyalgia.European journal of pain (London, England) · 2022Article
- Detecting anxiety and depression among people with limited literacy living with chronic low back pain in Nigeria: adaptation and validation of the hospital anxiety and depression scale.Archives of public health = Archives belges de sante publique · 2021Article
- Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi.Pilot and feasibility studies · 2021Article
- Influence of Sarcopenia on the Effect of Exercise Therapy for Elderly Patients with Chronic Low Back Pain.Spine surgery and related research · 2020Article
- A case control series for the effect of photobiomodulation in patients with low back pain and concurrent depression.Laser therapy · 2018Article
- Work and Mental Complaints: Are Response Outcome Expectancies More Important Than Work Conditions and Number of Subjective Health Complaints?Journal of occupational rehabilitation · 2017Article
- Measuring psychosocial factors in health surveys using fewer items.Health psychology openArticle
- Analysis of epidemiology, lifestyle, and psychosocial factors in patients with back pain admitted to an orthopedic emergency unit.Einstein (Sao Paulo, Brazil)Observational
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designCross-sectional study.
objectiveTo examine the sensitivity of 2 single-item questions compared with 2 longer questionnaires for screening depression and anxiety among patients with chronic low back pain (CLBP). SUMMARY OF BACKGROUND DATA: Psychosocial factors are frequently identified as risk factors for developing CLBP and as predictors for treatment, and questionnaires are often used to screen for this. Shorter instruments may be easier to use in clinical practice settings.
methodsA total of 564 patients with 2 to 10 months of at least 50% sickness absence due to nonspecific low back pain were assessed for depression and anxiety with the Mini-International Neuropsychiatric Interview (MINI). Single-item questions for depression and anxiety from the Subjective Health Complaint Inventory and 2 longer questionnaires, the Hospital Anxiety and Depression Scale and Hopkins Symptom Checklist-25, were compared with MINI results, considered the "gold standard" in this study. Sensitivity and specificity of single-item and longer questionnaires and receiver operating characteristic curves were compared.
resultsAccording to MINI, the prevalence of anxiety disorders was 12% whereas that of depressive disorders was 4%. The screening questions showed 95% sensitivity and 56% specificity for depressive disorders and 68% sensitivity and 85% specificity for anxiety disorders. The longer questionnaire, Hospital Anxiety and Depression Scale, showed 91% sensitivity and 85% specificity for depressive disorders and 58% sensitivity and 83% specificity for anxiety disorders. Hopkins Symptom Checklist-25 showed 86% sensitivity and 74% specificity for depressive disorders and 67% sensitivity and 87% specificity for anxiety disorders. For 3 of the anxiety disorders and 2 of the depressive disorders, a perfect sensitivity was found between the screening questions and MINI.
conclusionsA single-item screening question was sensitive for depression but less sensitive for anxiety. The screening questions further performed equal to 2 widely used questionnaires. Validation of these results in other populations and compared with other short-item screeners is needed.
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