ArticleChronic spinal pain and physical–mental comorbidity in the United States: results from the national comorbidity survey replicationVon Korff, Michaela,*; Crane, Paulb; Lane, Michaelc; Miglioretti, Diana L.a; Simon, Grega; Saunders, Kathleena; Stang, Pauld; Brandenburg, Nancye; Kessler, RonaldcAuthor Information aCenter for Health Studies, Group Health Cooperative, 1730 Minor Avenue Suite 1600, Seattle, WA 98101, USA bDepartment of Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA cDepartment of Health Care Policy, Harvard University, Boston, MA, USA dGalt Associates Inc., and Adjunct, University of NC at Chapel Hill School of Public Health, Chapel Hill, NC, USA ePfizer Inc., New York, NY, USA *Corresponding author. Tel.: +1 206 287 2874; fax: +1 206 287 2871. E-mail address:[email protected] Received 8 July 2004; received in revised form 28 October 2004; accepted 15 November 2004. Pain: February 2005 - Volume 113 - Issue 3 - p 331-339 doi: 10.1016/j.pain.2004.11.010 Buy Metrics Abstract This paper investigates comorbidity between chronic back and neck pain and other physical and mental disorders in the US population, and assesses the contributions of chronic spinal pain and comorbid conditions to role disability. A probability sample of US adults (n=5692) was interviewed. Chronic spinal pain, other chronic pain conditions and selected chronic physical conditions were ascertained by self-report. Mood, anxiety and substance use disorders were ascertained with the Composite International Diagnostic Interview (CIDI). Role disability was assessed with questions about days out of role and with impaired role functioning. The 1 year prevalence of chronic spinal pain was 19.0%. The vast majority (87.1%) of people with chronic spinal pain reported at least one other comorbid condition, including other chronic pain conditions (68.6%), chronic physical conditions (55.3%), and mental disorders (35.0%). Anxiety disorders showed as strong an association with chronic spinal pain as did mood disorders. Common conditions not significantly comorbid with chronic spinal pain were diabetes, heart disease, cancer, and drug abuse. Chronic spinal pain was significantly associated with role disability after controlling for demographic variables and for comorbidities. However, comorbid conditions explained about one-third of the gross association of chronic spinal pain with role disability. We conclude that chronic spinal pain is highly comorbid with other pain conditions, chronic diseases, and mental disorders, and that comorbidity plays a significant role in role disability associated with chronic spinal pain. The societal burdens of chronic spinal pain need to be understood and managed within the context of comorbid conditions. © 2005 Lippincott Williams & Wilkins, Inc.