Reviewer ’s report  
 
Title: Psychological distress and self -rated health status in reproduc tive aged women with pain: 
findings from a national, cross -sectional survey  
 
Version: 0 Date: 06 Dec 2018  
 
Reviewer: Mohsen Paknejad  
 
Reviewer's report:  
 
 The rational and purpose of the study is clear.  
 
 It needs the authors clearly state that they measured acute pain not chronic pain because the 
respondent rate their pain in the last four weeks.  
 
 The sampling method of 4380 women 18 to 49 yrs. from overall included sample 20460 
needs to be define and explain.  
 
 Measuring pain severity (one question with 3 limited options) and Self -rated health status 
(one question) are one of the main limitation of study.  
 
 The reason of conducting non -parametric test like Chai Square to analysis the data is not 
clear. Because the pain severity and self -rated health could have treated as metric variable.   
 
 The reported p value for the dist ribution of self -rated health status by pain severity is not 
defined to understand that it is a ANOVA test or Chai Square. The other issue related to the 
error bars with 95% confidence intervals seems it is a summary of two categorical bar chart 
in three g roups because the Y Axes of error bar chart should be the mean not a percentage 
axes.  
 
 It would be valuable to present the prevalence of pain severity, psychological distress and 
self-rated health status in reproductive aged women due to this fact that s uch information is 
not available in the background.   
 
 Discussion part needs to be organised according to two hypotheses and clearly state that the 
hypothesis is supported by finding or not.  
 
 Paragraph with the line number 153 to 161 are new information  from previous study that can 
move to introduction section of the manuscript.  
  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the author s. 
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your commen ts to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?   
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of compe ting interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relatin g to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I h ave no competing interests  
 
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