Premorbid psychosocial factors are associated with poor health-related quality of life in subjects with new onset of chronic widespread pain - results from the EPIFUND study.
Premorbid psychosocial factors are associated with poor health-related quality of life in subjects with new onset of chronic widespread pain - results from the EPIFUND study.
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DOI：
10.1016/j.pain.2008.10.022
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发表时间：
2009-01
期刊：
影响因子：
7.4
通讯作者：
McBeth J
中科院分区：
文献类型：
--
作者：
Nicholl BI;Macfarlane GJ;Davies KA;Morriss R;Dickens C;McBeth J
慢性广泛性疼痛（CWP）与健康相关生活质量（HRQoL）差相关。目前尚不清楚疼痛本身是否是HRQoL不良的原因或其他因素发挥作用。我们假设新发CWP与不良的身体和精神HRQoL相关，但CWP发病的心理社会风险标志物可以解释这种关系。一项基于人群的前瞻性调查测量了基线时的疼痛和心理社会状态。基线时无CWP的受试者在15个月后随访，评估疼痛状态、威胁生命事件和HRQoL（SF-12）。使用多项logistic回归（相对风险比（RRRs）和95%置信区间（95% CI）），对新发CWP和报告SF 12-MCS和SF 12-PCS不良相关的风险进行量化，并根据年龄和性别进行调整。3000例（77%）基线时无CWP的受试者参加了随访。2650例受试者（88%）提供了完整的SF-12和疼痛数据，并组成了本分析的队列。9.4%的受试者（n = 248）报告了新发CWP。新发CWP与SF 12-MCS（RRR = 2.3; 95% CI 1.6-3.2）和SF 12-PCS（RRR = 8.0; 95% CI 5.4-11.8）评分最差的风险增加相关。在调整基线心理社会状态后，CWP发作与SF 12-MCS之间的关系减弱（RRR = 1.2; 95% CI 0.8-1.8），尽管与SF 12-PCS之间的关系仍然存在（RRR = 4.8% CI 3.1-7.47）。新发CWP与不良的精神和身体HRQoL相关。然而，与精神HRQoL的关系是由心理社会风险标志物解释的。
Chronic widespread pain (CWP) is associated with poor health-related quality of life (HRQoL). It is unclear whether pain itself is the cause of poor HRQoL or other factors play a role. We hypothesised that new onset of CWP was associated with poor physical and mental HRQoL but that psychosocial risk markers for CWP onset would explain this relationship. A prospective population-based survey measured pain and psychosocial status at baseline. Subjects free of CWP at baseline were followed up 15 months later, when pain status, threatening life events and HRQoL (SF-12) were assessed. The risk associated with the new onset of CWP and reporting poor SF12-MCS and SF12-PCS was quantified using multinomial logistic regression (relative risk ratios (RRRs) with 95% confidence intervals (95% CI)), adjusted for age and gender. 3000 subjects (77%) free of CWP at baseline participated at follow-up. 2650 subjects (88%) provided full SF-12 and pain data and formed the cohort for this analysis. 9.4% of subjects (n = 248) reported new CWP. New CWP was associated with an increased risk of having the poorest SF12-MCS (RRR = 2.3; 95% CI 1.6–3.2) and SF12-PCS (RRR = 8.0; 95% CI 5.4–11.8) scores. After adjusting for baseline psychosocial status, the relationship between CWP onset and SF12-MCS was attenuated (RRR = 1.2; 95% CI 0.8–1.8), although the association with SF12-PCS remained (RRR = 4.8% CI 3.1–7.47). New onset of CWP is associated with poor mental and physical HRQoL. However, the relationship with mental HRQoL is explained by psychosocial risk markers.
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影响因子：
5.5
作者：
Gupta, A.;Silman, A. J.;McBeth, J.
通讯作者：
McBeth, J.
影响因子：
3
作者：
MCHORNEY, CA;WARE, JE;RACZEK, AE
通讯作者：
RACZEK, AE
影响因子：
7.4
作者：
Crombez, Geert;Ecceleston, Christopher;De Vlieger, Petra
通讯作者：
De Vlieger, Petra
影响因子：
--
作者：
McBeth, J;Silman, AJ;Macfarlane, GJ
通讯作者：
Macfarlane, GJ
影响因子：
27.4
作者：
Carmona, L;Ballina, J;Laffon, A
通讯作者：
Laffon, A