Quality of life and pain in premenopausal women with major depressive disorder: the POWER Study.
Quality of life and pain in premenopausal women with major depressive disorder: the POWER Study.
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DOI：
10.1186/1477-7525-4-2
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发表时间：
2006-01-18
影响因子：
3.6
通讯作者：
Cizza, Giovanni
中科院分区：
文献类型：
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作者：
Hartman, Jill M;Berger, Ann;Cizza, Giovanni
背景：虽然已经确定器质性疼痛可能诱发抑郁症，但尚不清楚疼痛是否在患有抑郁症的健康受试者中更常见。我们评估了患有重度抑郁症 (MDD) 的绝经前女性的疼痛患病率。受试者为患有 MDD 的 21 至 45 岁绝经前女性（N = 70；年龄：35.4 +/- 6.6；平均值 +/- SD）和健康匹配对照（N = 36；年龄 35.4 +/- 6.4），参与骨转换研究，即 P.O.W.E.R. （绝经前、骨质减少/骨质疏松症、女性、阿仑膦酸钠、抑郁症）研究。方法：患者接受疼痛专家的临床评估，其中包括对疼痛进行两种标准化形式的管理，即简短疼痛量表 - 简短形式和初始疼痛评估工具，以及两种日常压力源量表，即麻烦量表和提升量表。此外，还使用了生活质量仪器 SF-36。根据 DSM-IV 标准，MDD 的诊断是通过半结构化访谈确定的。 P 物质 (SP) 和降钙素基因相关肽 (CGRP) 是已知的疼痛介质神经肽，在一组患者 (N = 17) 和对照 (N = 14) 中每小时测量一次，持续 24 小时。 结果：大约一半的抑郁症女性报告有轻度疼痛。疼痛强度与抑郁的严重程度显着相关（r2 = 0.076；P = 0.04），并且往往与焦虑的严重程度（r2 = 0.065；P = 0.07）和抑郁发作次数相关（r2 = 0.072；P = 0.09）。患有重度抑郁症的女性抱怨疲劳、失眠和记忆问题，并且比对照组更频繁地经历日常负面压力。 SF-36 的情感和社会幸福感领域得分较低表明患有抑郁症的女性的生活质量下降。抑郁症受试者的 SP (P < 0.0003) 和 CGRP (P < 0.0001) 较高。结论：患有抑郁症的女性比对照组更频繁地经历疼痛，生活质量较低，并且抱怨日常压力更大。疼痛评估对于患有 MDD 的女性的临床评估可能很重要。 SP 和 CGRP 可能是患有 MDD 的女性的有用生物标志物。
BACKGROUND: Whereas it is established that organic pain may induce depression, it is unclear whether pain is more common in healthy subjects with depression. We assessed the prevalence of pain in premenopausal women with major depression (MDD). Subjects were 21- to 45-year-old premenopausal women with MDD (N = 70; age: 35.4 +/- 6.6; mean +/- SD) and healthy matched controls (N = 36; age 35.4 +/- 6.4) participating in a study of bone turnover, the P.O.W.E.R. (Premenopausal, Osteopenia/Osteoporosis, Women, Alendronate, Depression) Study.METHODS: Patients received a clinical assessment by a pain specialist, which included the administration of two standardized forms for pain, the Brief Pain Inventory - Short Form, and the Initial Pain Assessment Tool, and two scales of everyday stressors, the Hassles and Uplifts Scales. In addition, a quality-of-life instrument, the SF-36, was used. The diagnosis of MDD was established by a semi-structured interview, according to the DSM-IV criteria. Substance P (SP) and calcitonin-gene-related-peptide (CGRP), neuropeptides which are known mediators of pain, were measured every hour for 24 h in a subgroup of patients (N = 17) and controls (N = 14).RESULTS: Approximately one-half of the women with depression reported pain of mild intensity. Pain intensity was significantly correlated with the severity of depression (r2 = 0.076; P = 0.04) and tended to be correlated with the severity of anxiety, (r2 = 0.065; P = 0.07), and the number of depressive episodes (r2 = 0.072; P = 0.09). Women with MDD complained of fatigue, insomnia, and memory problems and experienced everyday negative stressors more frequently than controls. Quality of life was decreased in women with depression, as indicated by lower scores in the emotional and social well-being domains of the SF-36. SP (P < 0.0003) and CGRP (P < 0.0001) were higher in depressed subjects.CONCLUSION: Women with depression experienced pain more frequently than controls, had a lower quality of life, and complained more of daily stressors. Assessment of pain may be important in the clinical evaluation of women with MDD. SP and CGRP may be useful biological markers in women with MDD.