Heterogeneous depression responses to chronic pain onset among middle-aged adults: a prospective study.
Heterogeneous depression responses to chronic pain onset among middle-aged adults: a prospective study.
复制标题
中年成年人慢性疼痛发作的异质抑郁反应：一项前瞻性研究。
DOI：
10.1016/j.psychres.2014.03.004
复制
发表时间：
2014
影响因子：
11.3
通讯作者：
Bonanno,GeorgeA
中科院分区：
文献类型：
--
作者：
Zhu,Zhuoying;Galatzer-Levy,IsaacR;Bonanno,GeorgeA
由于缺乏对不同形式的反应模式和横截面测量的澄清，有关抑郁症对慢性疼痛反应的研究受到限制。目前的研究使用混合建模技术前瞻性地研究了抑郁症对慢性疼痛发作的长期异质反应模式。在全国代表性的中年样本中绘制了六年内疼痛发作前后的抑郁症状。出现了四种不同的抑郁症状轨迹。弹性（72.0%）轨迹描述了疼痛发作之前和之后没有/最小抑郁症状的模式。疼痛后抑郁轨迹（11.4%）描述了基线时抑郁程度较低以及疼痛发作后症状加重的模式。慢性抑郁症（6.8%）轨迹的特点是无论疼痛是否发作，抑郁症状持续较高。之前的抑郁症改善（9.8%）轨迹描述了基线时高度抑郁的模式，以及疼痛发作后症状逐渐减轻的模式。基线和疼痛发作后的自评健康状况可预测弹性轨迹。基线自评健康状况区分了疼痛后抑郁症和慢性抑郁症轨迹。与处于恢复力或疼痛后抑郁轨迹中的个体相比，处于先前抑郁改善轨迹中的个体年龄更大，基线时患有更多慢性疾病，但疼痛发作后的疾病较少。
Studies on depression response to chronic pain are limited by lack of clarification of different forms of response patterns and cross-sectional measures. The current study examined heterogeneous long-term patterns of depression response to chronic pain onset prospectively using the mixture modeling technique. Depression symptoms prior to and following pain onset over a course of six years were charted in a nationally representative middle-aged sample. Four distinct depression symptom trajectories emerged. Theresilience(72.0%) trajectory describes a pattern of no/minimal depression symptoms prior to and following pain onset. Thepost-pain depressiontrajectory (11.4%) describes a pattern of low depression at baseline and increasing symptoms following pain onset. Thechronic depression(6.8%) trajectory is characterized by persistently high depression symptoms irrespective of pain onset. Theprior depression improved(9.8%) trajectory describes a pattern of high depression at baseline and gradually declining symptoms following pain onset. Self-rated health at both baseline and following pain onset predicted theresiliencetrajectory. Baseline self-rated health distinguished thepost-pain depressionandchronic depressiontrajectories. Individuals in theprior depression improvedtrajectory were older and had more chronic illnesses at baseline but fewer illnesses following pain onset, compared to those in theresilienceorpost-pain depressiontrajectory.