in Projekten blättern
Angaben zum Forschungsprojekt
Depression als Prädiktor für den Misserfolg in der Rehabilitation von chronischem Rückenschmerz
Hintergrund und Fragestellung:
Bezug des Projekts zur internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF):
Der bio-psycho-soziale Ansatz der ICF bildet einen konzeptionellen Bezugsrahmen für das Projekt.
Deutsche Rentenversicherung Oldenburg-Bremen
Depression as Predictor of the Success of Rehabilitation in Patients with Chronic Back Pain
Chronically ill patients showed a 1.4 to twice higher risk of developing mental disorders of which affective disorders occur most frequently. Mental disorders contribute decisively to an adverse prognosis of chronically ill patients. So far little is known in which way mental disorders affect the effectiveness of rehabilitation in chronically ill patients; but adverse effects are presumed. In total, psycho-logical treatments during rehabilitation were proven to be insufficient. Bio-psycho-social concepts for the treatment of patients are required which so far have not been implemented sufficiently in the orthopedic rehabilitation.
The aim of a first phase is to identify predictors of the success of rehabilitation in patients with chronic back pain in an in-patient setting. In the first study, 150 patients with chronic back pain were examined ( diagnosis: M54.4, 54.5). In particular, the influence of age, gender, and depressive symptoms were investigated. Socio-demographic, socio-medical, physical, and psychosocial data were collected directly immediately, 3 and 6 months after rehabilitation. The socio-medical data comprised frequency and duration of work in-capacity, intended retirement, intended reduction in work capacity, degree of disability as well as self-assessment of i) return to work after rehabilitation, and ii) capacity to work until reaching retirement age. Physical data included pain relevant measures and functional status (FFbH). The chronic stage of pain was assessed (MPSS). Psychosocial data consisted of work dissatisfaction, health-related quality of life (SF), somatisation (SCL), depressive and anxiety symptoms (ADS; HADS). Additionally, sensoric and affective pain perception (SES), coping with pain (FESV), and reactions of significant others on pain (MPI-D) were measured.
In the second study the effectiveness of rehabilitation of a standard treatment and psychotherapeutic care is compared with standard treatment without psychotherapeutic care for patients with chronic back pain and depressive symptoms depending on gender. Three groups are examined: 70 patients with chronic back pain and depressive symptoms with the combined treatment (standard and psychotherapeutic treatment), 70 patients with chronic back pain and depressive symptoms with the standard treatment only, and the additional control group of 70 patients with chronic back pain but without depressive symptoms with the standard treatment only. Socio-demographic, socio-medical, physical, and psychosocial data were collected directly immediately, 6 and 12 months after rehabilitation.