Accuracy of screening for symptoms of anxiety and depression among patients with chronic neck, shoulder, or low back pain in private physiotherapy practices

Abstract

Translate Article

Take Notes

Background Chronic neck, shoulder, and low back pain are among the most common causes of disability worldwide. These conditions frequently co-occur with symptoms of anxiety and depression, which can negatively impact clinical outcomes. Early identification of psychological symptoms is essential but physiotherapists’ accuracy in detecting these symptoms is unclear. Objectives Evaluate the accuracy of the observer-based Generalised Anxiety Disorder-2 (GAD-2) and Patient Health Questionnaire-2 (PHQ-2), compared to a numeric rating scale (NRS) in screening for anxiety and depression symptoms in patients with chronic neck, shoulder, and/or low back pain. Methods Sixty-three physiotherapists and their 390 patients with chronic neck, shoulder, and/or low back pain were recruited. Physiotherapists screened for symptoms of anxiety and depression using the observer-based GAD-2, PHQ-2, and a 0-to-10 NRS. Patients completed the Generalised Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Receiver operating characteristic (ROC) curves were generated to calculate the accuracy of the screening tools compared to the NRS in detecting symptoms of anxiety and depression. The area under ROC curves (AUC) was used to determine the discriminative ability of each tool. Results The observer-based GAD-2 and PHQ-2 are more accurate in screening mild to moderate symptoms of anxiety and depression compared to the NRS. Conclusion Physiotherapists screen anxiety and depression symptoms more accurately using the observer-based GAD-2 and PHQ-2 in patients with chronic neck, shoulder and/or low back pain. Therefore, these screening tools are preferable to the NRS for these patients.