Prevalence of psychiatric disorders in patients with chronic disabling occupational spinal disorders
Prevalence of psychiatric disorders in patients with chronic disabling occupational spinal disorders
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DOI：
10.1097/01.brs.0000216441.83135.6f
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发表时间：
2006-05-01
期刊：
影响因子：
3
通讯作者：
Temple, OR
中科院分区：
文献类型：
--
作者：
Dersh, J;Gatchel, RJ;Temple, OR
研究设计.一项患病率研究。目的。使用可靠有效的诊断工具评估大量慢性致残性职业性脊柱疾病（CDOSD）患者中精神疾病的患病率。背景资料概要。虽然未被识别和未经治疗的精神疾病已被发现干扰CDOSD患者的成功治疗，目前几乎没有数据可供有关的精神特征的患者声称与工作有关的伤害，导致CDOSDs.Methods。采用精神疾病诊断和统计手册对连续一组CDOSD患者（n = 1，323）在三级转诊中心就诊的CDOSD患者的精神疾病进行诊断。与一般人群的基本患病率相比，CDOSD患者的精神疾病总体患病率显著升高。大多数（65%）患者被诊断患有至少一种当前疾病（不包括疼痛障碍，这在该人群中几乎是普遍的），而一般人群中只有15%。最常见的诊断为重度抑郁症（56%）、物质使用障碍（14%）、焦虑症（11%）和轴II型人格障碍（70%）。治疗CDOSD患者的临床医生必须意识到这一人群中精神疾病的高患病率。他们还必须准备使用心理健康专业人员来帮助他们识别和稳定这些患者。未能遵循生物心理社会的方法来治疗可能会导致长期残疾，在相当数量的这些慢性疼痛患者。
Study Design. A prevalence study.Objectives. To assess the prevalence of psychiatric disorders among a large group of patients with chronic disabling occupational spinal disorders (CDOSDs), using a reliable and valid diagnostic instrument.Summary of Background Data. Although unrecognized and untreated psychiatric disorders have been found to interfere with successful treatment of CDOSD patients, little data are currently available regarding the psychiatric characteristics of patients claiming work-related injuries that result in CDOSDs.Methods. Psychiatric disorders in a consecutive group of CDOSD patients (n = 1,323) attending a tertiary referral center for patients with CDOSD were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders.Results. Overall prevalence of psychiatric disorders was found to be significantly elevated in CDOSD patients compared with base rates in the general population. A majority (65%) of patients were diagnosed with at least one current disorder (not including Pain Disorder, which is nearly universal in this population), compared with only 15% of the general population. Major Depressive Disorder (56%), Substance Use Disorders (14%), Anxiety Disorders (11%), and Axis II Personality Disorders (70%) were the most common diagnoses.Conclusions. Clinicians treating CDOSD patients must be aware of the high prevalence of psychiatric disorders in this population. They must also be prepared to use mental health professionals to assist them in identifying and stabilizing these patients. Failure to follow a biopsychosocial approach to treatment will likely contribute to prolonged disability in a substantial number of these chronic pain patients.