Exploring the link between anxiety, depression and somatization with pain severity in chronic low back pain patients: a survey at a tertiary care hospital

BACKGROUND: Chronic low back pain (CLBP) is a major cause of disability worldwide and is strongly associated with anxiety, depression, and somatization. This study assessed the prevalence of these psychopathologies and their relationship with pain severity in Pakistani CLBP patients. OBJECTIVE: To determine the prevalence of anxiety, depression, and somatization and evaluate their predictive value for pain severity in CLBP. METHODOLOGY: A cross-sectional study was conducted from April to October 2024 at Jinnah Postgraduate Medical Center, Karachi. Fifty-eight CLBP patients and 58 healthy controls completed PHQ-9, GAD-7, and PHQ-15 questionnaires. Statistical analyses included Chi-square, Mann-Whitney U, and ordinal logistic regression. RESULTS: = 0.009, OR = 0.141, 95% CI: 0.033-0.607), unexpectedly associating higher depression with lower reported pain severity. Anxiety and somatization were not significant predictors. CONCLUSION: Psychological distress is highly prevalent in CLBP, supporting its biopsychosocial nature. The inverse relationship between depression and pain severity warrants further investigation, while routine psychological screening and multidisciplinary care remain essential.