1. Sense of emotional support in chronic low back pain patients Tarass Ivascenko Tarass Ivascenko, Daina Smite, Gunta Ancane Riga Stradins University LATVIA Aarhus 2012

2. European Federation of International Association for Study of Pain (EFIC) has made the declaration on chronic pain as a major healthcare problem. One of the most common types of chronic pain is chronic low back pain.

3. European Federation of International Association for Study of Pain (EFIC) has made the declaration on chronic pain as a major healthcare problem. One of the most common types of chronic pain is chronic low back pain.

4. European Federation of International Association for Study of Pain (EFIC) has made the declaration on chronic pain as a major healthcare problem. One of the most common types of chronic pain is chronic low back pain.

5. Despite different treatment methods, for approximatly 30% of patients acute back pain turns into chronic pain syndrome. Waddel, 2004; Keef et al, 2004; Linton, 2005; Freburger et al, 2009; Nachemson, 2000; Nieuwenhuyse et al, 2009

6. social epidemic Chronic back pain and disability caused by it, is called the social epidemic. (Nachemson, 2004)

7. The results of clinical studies have confirmed pathogenetic factors of low back pain : -physical -social -emotional Freburger et al, 2009; Langworthy et al, 2007; Gunzman et al, 2006; Keef et al, 2004; Waddel, 2004; Linton, 2005; Nachemson, 2000

8. Sense of emotional support The feeling of being loved, valued and unconditionally accepted The feeling of being loved, valued and unconditionally accepted has been shown to be central to the construct of emotional support (Sarason, Pierce, Sarason, 1990) Sense of emotional support have beneficial effects on the individual's adaption to chronic disease, it reduce the effects of stress and help individuals to cope (Cohen and Wills, 1985)

9. The purpose: sense of emotional support its interaction to analyse sense of emotional support and its interaction with pain syndrome pain syndrome manifestation, emotional distress emotional distress and the quality of life the quality of life in patients with chronic low back pain.

10. Material (I) n = 110 patients 62 female and 48 male mean age 44,2  8,0 years

11. Material (II) Clinical diagnosis: lumbar spine disk pathology with radiculopathy (after ICD -10: M 51.1.) Primary complaint: low back pain in duration >3 months

12. Assessment methods Structured clinical interview Visual analogue scale Assessment of emotional state: – Hospital Anxiety and Depression Scale (HADS) – sense of emotional support (family, friends, work; health care professionals) Health related quality of life: SF-36® Health Survey

13. Results 37,3% increased levels of anxiety in association with clinically significant symptoms of depression. 37,3% of patients had emotional distress (ED) which was manifested with increased levels of anxiety and in association with clinically significant symptoms of depression.

14. Patients with ED have less sense of emotional support:

16. Correlations Results of Spearman correlations analyses in both groups

17. Manifestation of ED is connected with worse self-rated quality of life (results of SF-36):

18. 1. Patients with CLBP divide in two groups – with and without emotional distress. 2. Patients with and without ED have different sense of emotional support. 3. High level of sense of emotional support decreases pain intensity.

19. 4. Low level of sense of emotional support increases emotional distress. 5. Patients with emotional distress have lower quality of life. 6. There is need for assessment of emotional distress to provide more successful treatment.

21. Thank you for attention! dr. Tarass Ivascenko Department of Psychosomatic Medicine and Psychotherapy Riga Stradins University 23 Kapseļu Str., Riga, LV-1046, Latvia Phone: +371 67210989 Mob.: +371 29881571 e-mail: Taras.Ivascenko@rsu.lvTaras.Ivascenko@rsu.lv www.rsu.lv www.psihosomatika.lv