Trajectories of Low Back Pain From Adolescence to Young Adulthood

Objective: Despite the high prevalence and burden of low back pain (LBP), understanding of its course during the transition from adolescence to adulthood is limited. The aim of this study was to identify and describe trajectories of LBP and its impact among a general population sample followed from adolescence to young adulthood. Methods: Data from followup assessments at years 17, 20, and 22 of the Western Australian Pregnancy Cohort (Raine) Study were used (n = 1,249). Self-reported LBP and its impact on daily life were assessed, and latent class analysis was used to identify clusters. Resultant clusters were profiled on sex, waist circumference, diagnosed comorbid pain, and health-related quality of life. Results: Four clusters were identified: a cluster of participants with a consistently low prevalence of LBP and its impact (53%) during the period from adolescence to young adulthood, a cluster with an increase in the prevalence of LBP and its impact (22%), a cluster with a decrease in the prevalence of LBP and its impact (15%), and a cluster with a consistently high prevalence of LBP and its impact (10%). These clusters differed markedly on the profiling variables. Conclusion: The identified clusters provide unique information on LBP and its impact during the transition from adolescence to young adulthood. Consideration of these trajectories could be important in the design of early prevention and management strategies

Psychometric evaluation of the Hospital Anxiety and Depression Scale in a large community sample of adolescents in Hong Kong

Purpose: The Hospital Anxiety and Depression Scale (HADS) is widely used in adult populations; however, its usefulness with adolescents has been explored less. This study sought to evaluate the reliability, validity, and factor structure of the Chinese version of HADS in a community sample of adolescents residing in Hong Kong. Methods: A prospective cohort of 5,857 students recruited from 17 secondary schools completed the HADS. Internal consistency and concurrent validity were examined. Confirmatory factor analysis was applied to test the relative fits of six factor structures of the HADS. The best fitting model was further cross-validated by male, female, splithalf samples, and age subgroups. Results: The HADS possessed adequate internal consistency, especially for the anxiety subscale. Significant concurrent intercorrelations with self-reported suicidal thoughts and the Youth Self Report Anxious/Depressed subscale were discovered and found to be stronger for females. The cross-validation supported a two-factor model, where anxiety item 7, "I can sit at ease and feel relaxed", was placed in the depression subscale. Conclusions: The HADS showed satisfactory psychometric properties as a screening instrument in assessing anxious and depressive states as two correlated but distinct factors in adolescents. Study implications and recommendations for future research were discussed.published_or_final_versionSpringer Open Choice, 21 Feb 201