Chronic pain and major depressive disorder in the general population
Chronic pain and major depressive disorder in the general population
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DOI：
10.1016/j.jpsychires.2009.10.013
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发表时间：
2010-05-01
影响因子：
4.8
通讯作者：
Schatzberg, Alan F.
中科院分区：
文献类型：
--
作者：
Ohayon, Maurice M.;Schatzberg, Alan F.
本研究的目的是(1)评估慢性疼痛躯体状况(CPPC)和严重抑郁障碍(MDD)在普通人群中的患病率；(2)评估它们与睡眠和器质性障碍的相互作用和共同发病率；以及(3)调查它们的日常功能和社会职业后果。随机抽样调查了3243名代表加州居民的受试者(年龄为18岁)，接受了电话采访。CPPC持续时间至少6个月。调查次数、严重程度、持续时间和对日常功能、会诊、病假和治疗的影响。MDD采用DSM-IV标准进行评估。CPPC时点患病率为49%(95%可信区间：47.0~51.0%)。背部疼痛是最常见的；MDD的1个月患病率为6.3%(95%可信区间：5.5-7.2%)；66.3%的MDD受试者报告至少有一次CPPC。57.1%的患者疼痛出现在MOD之前。MDD受试者的疼痛程度因睡眠不佳、压力和疲倦而增加。在患有CPPC的MDD患者中，卧床、请病假和疼痛干扰日常功能的频率是患有CPPC的非MOD患者的两倍；患有CP的肥胖患者患MOD的可能性是非MOD患者的2.6倍。疼痛与抑郁障碍高度相关。它使身体、职业和社会专业活动恶化。疼痛和睡眠障碍是咨询的主要动机，而不是抑郁情绪，这突显了错过抑郁症诊断的风险。(C)2009爱思唯尔有限公司。保留所有权利。
This study aims (1) to assess the prevalence of Chronic Painful Physical Condition (CPPC) and major depressive disorder (MDD) in the general population; (2) to evaluate their interaction and co-morbidity with sleep and organic disorders; and (3) to investigate their daily functioning and socio-professional consequences. A random sample of 3243 subjects (>= 18 years), representative of California inhabitants, was interviewed by telephone. CPPC duration was at least 6 months. Frequency, severity, duration and consequences on daily functioning, consultations, sick leave and treatment were investigated. MDD were assessed using DSM-IV criteria. The point prevalence of CPPC was 49% (95% confidence interval: 47.0-51.0%). Back area pain was the most frequent; 1-month prevalence of MDD was at 6.3% (95% CI: 5.5-7.2%); 66.3% of MDD subjects reported at least one CPPC. In 57.1% of cases, pain appeared before MOD. Pain severity was increased by poor sleep, stress and tiredness in MDD subjects. Being confined to bed, taking sick leave and interference of pain with daily functioning were twice as frequent among MDD subjects with CPPC than in non-MOD subjects with CPPC; obese individuals with CP were 2.6 times as likely to have MOD. Pain is highly linked with depressive disorder. It deteriorates physical, occupational and socio-professional activities. Pain and sleep disturbances are a prime motive of consultation rather than depressed mood, underlining the risk of missing a depression diagnosis. (C) 2009 Elsevier Ltd. All rights reserved.