Chronic pain, depression, and quality of life: Correlations and predictive value of the SF-36
Chronic pain, depression, and quality of life: Correlations and predictive value of the SF-36
复制标题
DOI：
10.1111/j.1526-4637.2003.03040.x
复制
发表时间：
2003-12-01
期刊：
影响因子：
3.1
通讯作者：
Palcher, JA
中科院分区：
文献类型：
--
作者：
Elliott, TE;Renier, CM;Palcher, JA
目标。抑郁症是有效缓解疼痛的主要障碍。SF-36健康调查可能是一个有用的结果衡量慢性疼痛患者有或没有抑郁症。本研究旨在探讨SF-36心理综合量表t分与慢性疼痛患者抑郁类型的相关性，以及SF-36对慢性疼痛患者抑郁类型的阳性预测价值。慢性疼痛患者基线评估的横断面调查。背景。美国中北部跨学科疼痛管理中心。242例连续的慢性非癌性疼痛患者。评估患者报告的健康相关生活质量（SF-36）、疼痛、疼痛类型和诊断、心理健康诊断和患者人口统计学。结果的措施。SF-36健康调查，疼痛诊断和抑郁诊断。结果。研究参与者为160名女性（66%）和82名男性（34%），95%为白种人，平均年龄为46岁（±0.8 SD）（范围：19-83）。所有慢性疼痛的类型和诊断均有体现。重度抑郁症患病率为52%。抑郁类型与SF-36评分高度相关（r=-0.567; P < 0.001）。所有慢性疼痛患者的SF-36评分都很低。与美国人群相比，慢性疼痛患者伴抑郁和不伴抑郁的SF-36得分显著降低。慢性疼痛合并重度抑郁障碍患者的心理综合评分t-score分别为34.1分和47.6分，显著低于轻度抑郁和无抑郁患者（P < 0.001）。SF-36鉴别重度抑郁症与轻度抑郁症或无抑郁症的阳性预测值为98%（敏感性为84.4%，特异性为93.9%）。SF-36心理综合评分及各分量表与慢性疼痛患者抑郁类型高度相关。SF-36对抑郁症类型的阳性预测值较高。SF-36可能是衡量慢性疼痛患者健康相关生活质量的有用临床工具。此外，SF-36能够检测重度抑郁症，并证明慢性疼痛患者抑郁类型（严重程度）与健康相关生活质量之间存在剂量效应关系。
Objective. Depression is a major barrier to effective pain relief. The SF-36 Health Survey may be useful as an outcome measure for chronic pain patients with and without depression. The study purpose was to determine the correlation between the SF-36 Mental Composite Scale t-score and depression type in chronic pain patients and the positive predictive value of the SF-36 in classifying depression type in chronic pain patients.Design. Cross-sectional survey of chronic pain patients at baseline assessment.Setting. Interdisciplinary pain management center in the North Central United States.Patients. Two hundred forty-two consecutive, chronic noncancer pain patients.Interventions. Assessments of patient-reported health-related quality of life (SF-36), pain, pain type and diagnoses, mental health diagnoses, and patient demographics.Outcome measures. SF-36 Health Survey, pain diagnoses, and depression diagnoses.Results. Study participants were 160 women (66%) and 82 men (34%), 95% Caucasian, whose mean age was 46 (+/-0.8 SD) years (range: 19-83). All types and diagnoses of chronic pain were represented. The prevalence of major depressive disorder was 52%. The type of depression was highly correlated with SF-36 score (r=-0.567; P < 0.001). All chronic pain patients had very low SF-36 scores. Compared with U.S. population norms, chronic pain patients with and without depression had significantly lower SF-36 scores as measured by z-scores. Chronic pain patients with major depressive disorder had a significantly lower Mental Composite Score t-score than those with minor or no depression-34.1 and 47.6, respectively (P < 0.001). The positive predictive value of the SF-36 for differentiating major depression from minor or no depression was 98% (sensitivity=84.4%, specificity=93.9%).Conclusions. The SF-36 Mental Composite Score and all subscales were highly correlated with depression type in chronic pain patients. The positive predictive value of the SF-36 in classifying depression type was high. The SF-36 may be a useful clinical tool to measure health-related quality of life in chronic pain patients. In addition, the SF-36 was able to detect major depression and demonstrate a dose-effect relationship between depression type (severity) and health-related quality of life in chronic pain patients.