Using chronic pain to predict depressive morbidity in the general population
Using chronic pain to predict depressive morbidity in the general population
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DOI：
10.1001/archpsyc.60.1.39
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发表时间：
2003-01-01
影响因子：
--
通讯作者：
Schatzberg, AF
中科院分区：
文献类型：
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作者：
Ohayon, MM;Schatzberg, AF
背景：疼痛综合征被认为在抑郁症中起作用。本研究评估慢性（持续时间大于或等于6个月）疼痛身体状况（CPPCs）（关节/关节、肢体或背部疼痛、头痛或胃肠道疾病）的患病率及其与重度抑郁症的关系。方法：采用横断面电话调查方法，随机抽取18 980名年龄在15岁至100岁之间的英国、德国、英国等国家的普通人群进行调查。意大利，葡萄牙和西班牙。在使用睡眠评估系统的电话访谈中提供的答案是主要的结果衡量标准。访谈包括关于精神障碍和医疗状况的问题。关于痛苦的身体状况的数据是通过关于医疗、咨询和/或因医疗状况住院的问题和42种疾病的清单获得的。结果：在所有接受采访的受试者中，17.1%报告至少有1次CPPC（95%置信区间[CI]， 16.5%-17.6%）。16.5%的受试者存在至少一种抑郁症状（悲伤、抑郁、绝望、失去兴趣或缺乏快乐）（95% CI, 16.0%-17.1%）；27.6%的受试者至少有1例CPPC。4.0%的受试者被诊断为重度抑郁症；43.4%的受试者至少有1次CPPC，是无重度抑郁障碍受试者的4倍（优势比[OR]， 4.0; 95% CI, 3.5-4.7）。在logistic回归模型中，CPPC与重度抑郁症密切相关（OR：单独CPPC， 3.6； CPPC+非疼痛性医疗状况，5.2）；24小时疼痛的存在对重度抑郁症的诊断有独立贡献（OR, 1.6）。结论：CPPCs的存在增加了抑郁情绪的持续时间。寻求CPPC咨询的患者应系统地评估抑郁症。
Background: Pain syndrome is thought to play a role in depression. This study assesses the prevalence of chronic (greater than or equal to 6 months' duration) painful physical conditions (CPPCs) (joint/articular, limb, or back pain, headaches, or gastrointestinal diseases) and their relationship with major depressive disorder.Methods: We conducted a cross-sectional telephone survey of a random sample of 18 980 subjects from 15 to 100 years old representative of the general populations of the United Kingdom, Germany,. Italy, Portugal, and Spain. Answers provided during telephone interviews using the Sleep-EVAL system were the main outcome measure. Interviews included questions about mental disorders and medical conditions. Data on painful physical conditions were obtained through questions about medical treatment, consultations, and/or hospitalizations for medical conditions and a list of 42 diseases.Results: Of all subjects interviewed, 17.1% reported having at least 1 CPPC (95% confidence interval [CI], 16.5%-17.6%). At least 1 depressive symptom (sadness, depression, hopelessness, loss of interest, or lack of pleasure) was present in 16.5% of subjects (95% CI, 16.0%-17.1%); 27.6% of these subjects had at least 1 CPPC. Major depressive disorder was diagnosed in 4.0% of subjects; 43.4% of these subjects had at least 1 CPPC, which was 4 times more often than in subjects without major depressive disorder (odds ratio [OR], 4.0; 95% CI, 3.5-4.7). In a logistic regression model, CPPC was strongly associated with major depressive disorder (OR: CPPC alone, 3.6; CPPC+nonpainful medical condition, 5.2); 24-hour presence of pain made an independent contribution to major depressive disorder diagnosis (OR, 1.6).Conclusions: The presence of CPPCs increases the duration of depressive mood. Patients seeking consultation for a CPPC should be systematically evaluated for depression.