Journal of V. N. Karazin Kharkiv National University: Series Medicine · Published 2025-11-24 · DOI 10.26565/2313-6693-2025-57-04
Background. The International Association for the Study of Pain has dedicated 2024 to studying information about sex and gender differences in pain perception and modulation, emphasising that psychosocial mechanisms in pain perception depending on sex and gender require more detailed study, especially taking into account intercultural differences. Purpose – to assess the impact of psycho-emotional factors (stress, anxiety, depression and kinesiophobia) on pain intensity, disability and quality of life in patients with non-specific chronic lower back pain, taking into account gender differences. Materials and methods. A survey was conducted among 223 patients aged 18-60 with non-specific chronic pain syndrome to determine their socio-demographic characteristics and assess their psycho-emotional state using the Hospital Anxiety and Depression Scale Perceived Stress Scale-10, Tampa Scale of Kinesiophobia-11, quality of life Short Form-36 Health Survey and level of disability Oswestry Disability Index. Results. In women, psycho-emotional factors did not significantly affect the physical component of health Short Form-36 Health Survey, while in men, high levels of stress, anxiety and kinesiophobia significantly reduced it (p = 0.014; p = 0.007; p = 0.018). The mental component of Short Form-36 Health Survey deteriorated in both sexes: in women with stress and anxiety (p < 0.001) and kinesiophobia (p = 0.023), in men with stress and anxiety (p < 0.001), depression (p = 0.014) and kinesiophobia (p = 0.003). In women, depression (OR = 4.97; p = 0.030) and high levels of kinesiophobia (OR = 4.97; p = 0.030) increased the risk of severe pain, while in men, no psycho-emotional factor was associated with a significant increase in pain intensity (p > 0.05). In men, high levels of stress (p = 0.002), anxiety (p = 0.007), depression (p = 0.011) and kinesiophobia (p = 0.005) increased the risk of severe disability, while in women these associations were not found (p > 0.05). Conclusions. Psycho-emotional factors significantly worsen the course of low back pain and show clear gender differences: in women, they mainly increase pain and mental distress, while in men, they reduce physical and mental health and increase the risk of disability.
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