Psychological distress and disability in back pain patients: evidence of sex differences

Using a psychological screening questionnaire, the incidence of psychological distress in back pain patients attending a chiropractic out-patient clinic was sought. In contrast to other back pain populations, only a small proportion of the sample (7.2%) showed overt signs of psychological distress. However, a relatively large proportion of these patients (45%) were classified as at risk of developing significant psychological distress. Sex, age and clinical history appeared to have very little effect on the psychological classification of patients, although women scored significantly higher overall on the psychological questionnaires. The relationship between distress and patients' self-reported disability was also investigated and shown to be particularly sensitive to sex effects. Hence, psychological distress accounted for 1 and 32% of the total variance in disability scores in male and female patients, respectively.