Back–neck pain and symptoms of anxiety and depression: a population-based twin study

Abstract

Background. Clinical and epidemiological studies have shown an association between anxiety and depression and pain in the back and neck. The nature of this relationship is not clear. This study aimed to investigate the extent to which common genetic and environmental aetiological factors contribute to the covariance between symptoms of anxiety and depression and back–neck pain.Methods. Measures of back–neck pain and symptoms of anxiety and depression were part of a self-report questionnaire sent in 1992 to twins born in Norway between 1967 and 1974 (3996 pairs). Structural equation modelling was applied to determine to what extent back–neck pain and symptoms of anxiety and depression share genetic and environmental liability factors.Results. The phenotypic correlation between symptoms of anxiety and depression and back–neck pain was 0.31. Individual differences in both anxiety and depression and back–neck pain were best accounted for by additive genetic and individual environmental factors. Heritability estimates were 0.53 and 0.30 respectively. For back–neck pain, however, a model specifying only shared- and individual environmental effects could not be rejected. Bivariate analyses revealed that the correlation between back–neck pain and symptoms of anxiety and depression was best explained by additive genetic and individual environmental factors. Genetic factors affecting both phenotypes accounted for 60% of the covariation. There were no significant sex differences.Conclusion. The results support previous findings of a moderate association between back–neck pain and symptoms of anxiety and depression, and suggest that this association is primarily due to common genetic effects.