Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis
Depression, Inflammation, and Pain in Patients With Rheumatoid Arthritis
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DOI：
10.1002/art.24647
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发表时间：
2009-08-15
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影响因子：
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通讯作者：
Ishiguro, Naoki
中科院分区：
文献类型：
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作者：
Kojima, Masayo;Kojima, Toshihisa;Ishiguro, Naoki
Objective.抑郁症和炎症之间的联系已经被提出。在类风湿性关节炎（RA）患者中，疼痛是与抑郁和炎症相关的主要症状。我们研究了RA患者抑郁、炎症标志物C反应蛋白（CRP）水平和疼痛之间的独立相关性。总共有218名RA门诊患者完成了自我管理的问卷调查，使用贝克抑郁量表II来测量抑郁症状，并使用视觉模拟量表来量化他们的感知疼痛。同时测定功能障碍和CRP水平。抑郁评分与CRP水平呈轻度正相关（r = 0.46，P < 0.001）。抑郁评分（标准化β = 0.35，P < 0.001）和CRP水平（标准化β = 0.35，P < 0.001）与疼痛显著相关，即使在回归分析中调整了临床协变量。Logistic回归分析显示，抑郁评分和CRP水平对重度疼痛（疼痛评分在上三分位数）风险的联合作用呈线性增加。因此，考虑到身体和精神的临床方法可能会带来好处，并可以实现最佳的疼痛控制。
Objective. An association between depression and inflammation has been suggested. In patients with rheumatoid arthritis (RA), pain is a major symptom associated with depression and inflammation. We examined the independent associations between depression, the inflammation marker C-reactive protein (CRP) level, and pain in patients with RA.Methods. In total, 218 RA outpatients completed self-administered questionnaires, using the Beck Depression Inventory II to measure depressive symptoms and a visual analog scale to quantify their perceived pain. Functional disability and CRP level were also measured.Results. Depression scores were mildly and positively correlated with the CRP level (r = 0.46, P < 0.001). Both the depression score (standardized beta = 0.35, P < 0.001) and the CRP level (standardized beta = 0.35, P < 0.001) were significantly associated with pain, even after adjustment for clinical covariates in regression analysis. In logistic analysis, the combined effects on the risk of severe pain (pain score in the upper tertile) increased with depression scores and CRP levels linearly.Conclusion, Depression severity and inflammation were associated with each other and appeared to have independent effects on perceived pain. Therefore, a clinical approach that takes into account both the body and the mind could have benefits and could enable optimal pain control.