Depression, anxiety and positive outlook amongst patients presenting to an osteopathic training clinic : a prospective survey

Abstract

BACKGROUND: Depression and anxiety are associated with chronic musculoskeletal pain and its persistence, whereas positive psychological factors have been associated with decreased pain severity and interference. These psychological factors have an influence on the management and prognosis of patients with pain, yet there is a lack of data about the prevalence of these factors in osteopathic settings.

OBJECTIVE: To investigate the scores of depression, anxiety and positive outlook in patients presenting to an osteopathic training clinic using the Depression, Anxiety and Positive Outlook Scale (DAPOS), and to further the process of validation of the Positive Outlook subscale of the DAPOS by comparing it with the International Positive and Negative Affect Schedule Short Form (I-PANAS-SF).

METHOD AND PARTICIPANTS: A prospective survey was undertaken in an osteopathic training clinic. Questionnaires (n=600) were made available to a convenience sample of consenting patients aged 18 or over who presented to the clinic over a 5-month period in 2009. The questionnaire included 1) demographic information 2) clinical information and 3) psychological measures. A total of 274 participants completed questionnaires. Non-parametric data analysis methods were used as the data was not normally distributed.

RESULTS: Data from 268 respondents was analysed. The median scores for both the Depression and Anxiety subscales of the DAPOS were low (Depression: median = 7; range = 5-24; interquartile range = 5; and Anxiety: median = 4; range = 3-15, interquartile range = 3). For the Positive Outlook subscale, the median score was moderate to high (Positive Outlook: median = 12; range = 3-15, interquartile range = 3). The Positive Outlook subscale correlated moderately with the Positive Affect subscale of the I-PANAS-SF (τ = 0.38, p≤0.001) indicating moderate convergent validity between these measures.

CONCLUSION: The low median scores for the Depression and Anxiety subscales of the DAPOS indicate that depression and anxiety may not be dominant factors impacting on the management approach for the majority of patients in this setting. Further evidence is lent to the ability of the DAPOS to measure positive psychological factors alongside of negative measures.