The role of psychosocial factors in predicting the onset of chronic widespread pain: results from a prospective population-based study
The role of psychosocial factors in predicting the onset of chronic widespread pain: results from a prospective population-based study
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DOI：
10.1093/rheumatology/kel363
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发表时间：
2007-04-01
期刊：
影响因子：
5.5
通讯作者：
McBeth, J.
中科院分区：
文献类型：
--
作者：
Gupta, A.;Silman, A. J.;McBeth, J.
Objective.慢性广泛性疼痛（CWP）与临床环境和社区中的心理社会困扰密切相关。本研究的目的是确定社会心理困扰，寻求健康的行为，睡眠问题和创伤性生活事件的发展在社区的新病例的措施的贡献。在一项基于人群的前瞻性研究中，对3171名年龄在25-65岁之间的无CWP的成年人进行了15个月后的随访，以确定新的CWP患者。基线数据来自许多心理量表，包括疾病态度量表（IAS），躯体症状量表（SSC），医院焦虑和抑郁量表，睡眠问题量表和生活事件量表。324例受试者[10%，95%置信区间（CI）9.2，11.3]在随访时出现新的CWP。在对年龄和性别进行调整后，三个因素独立预测了CWP的发展：SSC评分≥ 3分[比值比（OR）1.8，95% CI 1.1，3.1]，IAS疾病行为子量表评分≥ 8分（OR 3.3，95% CI 2.3，4.8），睡眠问题量表评分为9分或以上（OR 2.7，95% CI 1.6，3.2）。暴露于所有三个因素的受试者新发CWP的几率是所有量表得分较低者的12倍。如果受试者表现出躯体化、健康寻求行为和睡眠不良的特征，则他们发展CWP的几率会大幅增加。心理社会困扰对CWP有很强的病因学影响。
Objective. Chronic widespread pain (CWP) is strongly associated with psychosocial distress both in a clinical setting and in the community. The aim of this study was to determine the contribution of measures of psychosocial distress, health-seeking behaviour, sleep problems and traumatic life events to the development of new cases of CWP in the community.Methods. In a population-based prospective study, 3171 adults aged 25-65 yrs free of CWP were followed-up 15 months later to identify those with new CWP. Baseline data were available on their scores from a number of psychological scales including Illness Attitude Scales (IAS), Somatic Symptom Checklist (SSC), Hospital Anxiety & Depression Scale, Sleep Problems Scale, and Life Events Inventory.Results. 324 subjects [10%, 95% confidence interval (CI) 9.2, 11.3] developed new CWP at follow-up. After adjustment for age and sex, three factors independently predicted the development of CWP: scoring three or more on the SSC [odds ratio (OR) 1.8, 95% CI 1.1, 3.1], scoring eight or more on the Illness Behaviour subscale of the IAS (OR 3.3, 95% CI 2.3, 4.8), and nine or more on the Sleep Problem Scale (OR 2.7, 95% CI 1.6, 3.2). Subjects exposed to all three factors were at 12 times the odds of new CWP than those with low scores on all scales.Conclusion. Subjects are at substantial increased odds of developing CWP if they display features of somatization, health-seeking behaviour and poor sleep. Psychosocial distress has a strong aetiological influence on CWP.