Influence of childhood behaviour on the reporting of chronic widespread pain in adulthood: results from the 1958 British Birth Cohort Study
Influence of childhood behaviour on the reporting of chronic widespread pain in adulthood: results from the 1958 British Birth Cohort Study
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DOI：
10.1093/rheumatology/keq052
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发表时间：
2010-10-01
期刊：
影响因子：
5.5
通讯作者：
Macfarlane, Gary J.
中科院分区：
文献类型：
--
作者：
Pang, Dong;Jones, Gareth T.;Macfarlane, Gary J.
目标.为了确定儿童期行为是否与成年后慢性广泛性疼痛（CWP）的可能性相关，以及任何此类关系是否通过成年后的心理困扰进行介导，使用一个基于大人口的出生队列。进行了一项前瞻性队列研究（1958年英国出生队列）。参与者于1958年出生时登记，并在整个童年和成年期进行随访。儿童行为的数据是从父母和教师那里收集的。在45岁时通过自我完成问卷收集关于疼痛的数据。使用Poisson回归估计风险比（RR）和95%CI，调整性别、儿童和成年时的社会阶层、儿童期常见症状和成年后的心理困扰。CWP在成年女性中的发生率略高于男性（12.9% vs 11.7%）。45岁时报告CWP的可能性增加，16岁（RR 1.04; 95% CI 1.02，1.05）、11岁（RR 1.02; 95% CI 1.01，1.03）和7岁（RR 1.01; 95% CI 1.00，1.02）时教师报告的行为评分每增加一个单位。那些在11岁和16岁时有严重行为障碍的评分的人在成年后患CWP的可能性增加（RR 1.95; 95% CI 1.47，2.59和RR 1.69; 95% CI 1.18，2.42）。在7岁、11岁和16岁（RR 2.14; 95%CI 1.43，3.21）时出现持续性行为问题的人与所有三个年龄段均无行为问题的人相比，相关性最强。父母报告的行为也显示出类似但稍弱的关联。结论。适应不良（社会）行为与儿童期和青春期以后长期CWP增加有关。
Objectives. To determine whether childhood behaviour is associated with the likelihood of chronic widespread pain (CWP) in adulthood, and any such relationship is mediated through adult psychological distress, using a large population-based birth cohort.Methods. A prospective cohort study (the 1958 British Birth Cohort) was conducted. Participants were enrolled at birth in 1958, and followed up throughout childhood and adulthood. Data on childhood behaviour were collected from parents and teachers. Data regarding pain were collected at the age of 45 years by self-completion questionnaire. Risk ratios (RRs) and 95% CIs were estimated using Poisson regression, adjusting for gender, social class in childhood and adulthood, childhood common symptoms and adult psychological distress.Results. CWP was slightly more common in adult females than males (12.9 vs 11.7%). There was an increased likelihood of reporting CWP at the age of 45 years with every unit increase in teacher-reported behaviour score at 16 (RR 1.04; 95% CI 1.02, 1.05), 11(RR 1.02; 95% CI 1.01, 1.03) and 7 years (RR 1.01; 95% CI 1.00, 1.02) of age. Those with scores indicating severe behaviour disturbances at 11 and 16 years of age had an increased likelihood of CWP in adulthood (RR 1.95; 95% CI 1.47, 2.59 and RR 1.69; 95% CI 1.18, 2.42, respectively). The strongest association was seen among those indicating persistent behaviour problems at 7, 11 and 16 years (RR 2.14; 95% CI 1.43, 3.21) of age, compared with those without at all three ages. Similar but slightly weaker associations were shown for parent-reported behaviour.Conclusion. Maladjusted (social) behaviour is associated with increased long-term CWP beyond childhood and adolescence.