Comorbidity of Mental Disorders and Chronic Pain: Chronology of Onset in Adolescents of a National Representative Cohort
Comorbidity of Mental Disorders and Chronic Pain: Chronology of Onset in Adolescents of a National Representative Cohort
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DOI：
10.1016/j.jpain.2015.06.009
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发表时间：
2015-10-01
期刊：
影响因子：
4
通讯作者：
Meinlschmidt, Gunther
中科院分区：
文献类型：
--
作者：
Tegethoff, Marion;Belardi, Angelo;Meinlschmidt, Gunther
本研究旨在估计1）青少年慢性疼痛和精神障碍的共同发生率，2）慢性疼痛和精神障碍之间的关联，以及3）青少年慢性疼痛和精神障碍发作的顺序。我们使用了来自全国科摩罗调查重复青少年补充资料（参与者年龄，13-18岁）的加权数据（N = 6，483）。终生慢性疼痛通过青少年自我报告进行评估;终生DSM-IV精神障碍通过WHO复合国际诊断访谈进行评估，并辅以父母报告。在这项研究的参与者中，6,476人中有1,600人（25.93%）在一生中经历过任何类型的慢性疼痛和任何精神障碍。所有类型的疼痛都与精神障碍有关。最实质性的时间关联是那些在慢性疼痛发作之前出现精神障碍的患者，包括情感障碍与头痛和任何慢性疼痛之间的时间关联;焦虑症与慢性背部/颈部疼痛、头痛和任何慢性疼痛之间的时间关联;行为障碍与头痛和任何慢性疼痛之间的时间关联;以及任何精神障碍与慢性背部/颈部疼痛、头痛和任何慢性疼痛之间的时间关联。研究结果表明，情感，焦虑和行为障碍是慢性疼痛的早期危险因素，从而突出了儿童精神障碍与疼痛医学的相关性。为了改善慢性疼痛的预防和干预，应考虑综合护理。(C)由Elsevier Inc.出版。代表美国疼痛协会
This study sought to estimate 1) the prevalence of the co-occurrence of, 2) the association between, and 3) the sequence of onset of chronic pain and mental disorders in adolescents. We used weighted data (N = 6,483) from the National Comorbidity Survey Replication Adolescent Supplement (participants' age, 13-18 years). Lifetime chronic pain was assessed by adolescent self-report; lifetime DSM-IV mental disorders were assessed by the WHO Composite International Diagnostic Interview, complemented by parent report. Among the participants in the study, 1,600 of 6,476 (25.93%) had experienced any type of chronic pain and any mental disorder in their lifetime. All types of pain were related to mental disorders. The most substantial temporal associations were those with onset of mental disorders preceding onset of chronic pain, including those between affective disorders and headaches and any chronic pain; between anxiety disorders and chronic back/neck pain, headaches, and any chronic pain; between behavior disorders and headaches and any chronic pain; and between any mental disorder and chronic back/neck pain, headaches, and any chronic pain.Perspective: Findings indicate that affective, anxiety, and behavior disorders are early risk factors of chronic pain, thereby highlighting the relevance of child mental disorders for pain medicine. To improve prevention and interventions for chronic pain, integrative care should be considered. (C) 2015 Published by Elsevier Inc. on behalf of the American Pain Society