Risk factors for persistent chronic widespread pain: a community-based study
Risk factors for persistent chronic widespread pain: a community-based study
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DOI：
10.1093/rheumatology/40.1.95
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发表时间：
2001-01-01
期刊：
影响因子：
5.5
通讯作者：
Silman, AJ
中科院分区：
文献类型：
--
作者：
McBeth, J;Macfarlane, GJ;Silman, AJ
背景。慢性广泛疼痛是纤维肌痛综合征的主要临床特征，在大多数临床患者中，这种疼痛是持续存在的。相比之下，在来自社区的患者中，只有一半的患者会持续疼痛，尤其是那些有心理困扰的患者。这种痛苦是否是疼痛的结果，还是与疼痛持续存在相关的更广泛的躯体化过程的表现，尚不清楚。 目的。我们在一项大型、前瞻性、基于人群的研究中测试了这样的假设：躯体化特征可以预测慢性广泛疼痛的持续性。方法。总体而言，根据包含疼痛图的详细调查问卷，从人口登记册中选出的 1953 名成年受试者中，总共有 252 名 (13%) 被归类为患有慢性广泛疼痛。患者还完成了一些心理社会工具，用于测量已知与躯体化相关的特征。 12 个月后，225 名 (91%) 的患者成功随访，并使用相同的仪器提供了疼痛状态的数据。结果。总共有 126 名 (56%) 患者在随访中报告了慢性广泛疼痛。 74 名 (33%) 报告有其他疼痛，25 名 (11%) 报告没有疼痛。持续性慢性广泛疼痛与高心理困扰和疲劳的基线测试分数密切相关。此外，这些受试者更有可能表现出一种疾病行为模式，其特征是经常就诊以发现扰乱日常活动的症状。持续性疼痛的患病率随着受试者接触的危险因素数量的增加而增加。结论。尽管几乎一半的慢性广泛性疼痛在一年内得到缓解，但这项研究首次证明，这些表现出躯体化特征的受试者更有可能患有持续的广泛性疼痛。这些发现对于识别和治疗导致持续性慢性广泛疼痛的毒物具有重要意义。
Background. Chronic widespread pain is the cardinal clinical feature of the fibromyalgia syndrome, which, in the majority of clinic patients, is persistent. By contrast, in community-derived patients, pain is persistent in only half of the affected individuals, particularly those with psychological distress. Whether such distress is a consequence of the pain or a manifestation of a wider process of somatization which is associated with the persistence of pain is unclear.Objectives. We tested in a large, prospective, population-based study thr hypothesis that features of somatization predict the persistence of chronic widespread pain.Methods. In all, 252 (13%) of 1953 adult subjects selected from a population register were classified as having chronic widespread pain based on a detailed questionnaire which included a pain drawing. Thr patients also completed a number of psychosocial instruments which measure features known to be associated with somatization. Two hundred and twenty-five (91%) of the patients were successfully followed up after 12 months and provided data on pain status using the same instruments.Results. In all, 126 (56%) patients reported chronic widespread pain at follow-up. 74 (33%) reported other pain acid 25 (11%) reported no pain. Persistent chronic widespread pain was strongly associated with baseline test scores for high psychological distress and fatigue. In addition, these subjects were more likely to display a pattern of illness behaviour characterized by frequent visits to medical practitioners for symptoms which disrupt daily activities. The prevalence of persistent pain increased with the number of risk factors the subjects were exposed to.Conclusions. Although almost half of the eases of chronic widespread pain resolved within 1 yr, this study has demonstrated for the first time that these subjects who display features of somatization are more likely to have widespread pain which persists. These findings have implications for the identification and treatment of poisons with persistent chronic widespread pain.