Chronic pain and comorbid mental health conditions: independent associations of posttraumatic stress disorder and depression with pain, disability, and quality of life
Chronic pain and comorbid mental health conditions: independent associations of posttraumatic stress disorder and depression with pain, disability, and quality of life
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DOI：
10.1007/s10865-015-9628-3
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发表时间：
2015-06-01
影响因子：
3.1
通讯作者：
Bair, Matthew J.
中科院分区：
文献类型：
--
作者：
Outcalt, Samantha D.;Kroenke, Kurt;Bair, Matthew J.
创伤后应激障碍(PTSD)和抑郁症都与慢性疼痛高度共存，并对疼痛和治疗结果产生有害影响，但慢性疼痛、PTSD和抑郁之间的关系的性质尚未完全阐明。这项研究调查了250名退伍军人事务部初级保健中重度慢性肌肉骨骼疼痛患者，他们参加了一项随机对照疼痛治疗试验。分析基线数据以检验创伤后应激障碍和严重抑郁与疼痛、心理状态、生活质量和残疾等多个领域的独立关联。创伤后应激障碍与这些变量密切相关，在多变量模型中，创伤后应激障碍和重度抑郁分别与这些领域有很强的独立相关性。创伤后应激障碍与重度抑郁症与心理、生活质量和残疾结局的关系相似，与疼痛的关系显著但略小。由于创伤后应激障碍和抑郁症与疼痛、心理状态、生活质量和残疾有独立的负相关，因此临床医生认识和治疗慢性疼痛患者的这两种精神障碍是很重要的。
Both posttraumatic stress disorder (PTSD) and depression are highly comorbid with chronic pain and have deleterious effects on pain and treatment outcomes, but the nature of the relationships among chronic pain, PTSD, and depression has not been fully elucidated. This study examined 250 Veterans Affairs primary care patients with moderate to severe chronic musculoskeletal pain who participated in a randomized controlled pain treatment trial. Baseline data were analyzed to examine the independent associations of PTSD and major depression with multiple domains of pain, psychological status, quality of life, and disability. PTSD was strongly associated with these variables and in multivariate models, PTSD and major depression each had strong independent associations with these domains. PTSD demonstrated similar relationships as major depression with psychological, quality of life, and disability outcomes and significant but somewhat smaller associations with pain. Because PTSD and major depression have independent negative associations with pain, psychological status, quality of life, and disability, it is important for clinicians to recognize and treat both mental disorders in patients with chronic pain.