Hypervigilance in the development of chronic pain

慢性疼痛发展中的过度警惕

• 批准号: nhmrc : 402524
• 负责人: Prof Ann Louise Sharpe
• 金额: $ 16.33万
• 依托单位: The University of Sydney
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2006
• 资助国家: 澳大利亚
• 起止时间: 2006-01-01 至 2008-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/hypervigilance-development-chronic-pain/98744
• 关键词: Hypervigilance; development; chronic; pain

Chronic pain is a common and debilitating condition. One in five people in the Australian community have been found to experience chronic pain at any one time. Although there is no evidence of a consistent increase in rates of chronic pain, the rate of permanent disability has increased dramatically in recent decades. This has contributed to the growing cost of chronic pain. For example, back pain is the most common reason for filing workers' compensation claims and leads to loss of 101.8 million workdays annually. The annual costs of medical care for back pain alone have been estimated at $AUD50 billion in the US and $10 billion in Australia. Not only is chronic pain a considerable economic burden, it is also a considerable personal burden to patients. Pain is one of the strongest predictors of poor quality of life and has consistently been found to be associated with high rates of depression. Although there is a large body of research that investigates what factors are associated with chronic pain, there is surprisingly little research that investigates the mechanisms that cause chronicity. Theories of chronic pain suggest that psychological characteristics increase the propensity for people to develop chronic pain. Specifically, theories argue that those people who tend to be fearful of pain will over-attend to painful sensations and avoid pain-provoking activities and as a result are at risk of developing chronic pain. This study will test those theories. If it is found that over-attending to pain does predispose patients to develop chronic pain, this will have important implications for preventing the development of chronic pain. These findings could help to devise early interventions to prevent chronicity and thereby reduce the economic burden to health services and the emotional burden to patients in terms of reduced quality of life.

慢性疼痛是一种常见的使人衰弱的疾病。在澳大利亚，五分之一的人在任何时候都会经历慢性疼痛。尽管没有证据表明慢性疼痛的发生率持续上升，但近几十年来，永久性残疾的发生率急剧上升。这导致慢性疼痛的成本不断上升。例如，背痛是提交工人赔偿要求的最常见原因，每年导致1.018亿个工作日的损失。据估计，每年仅背部疼痛的医疗费用在美国就高达500亿澳元，在澳大利亚为100亿美元。慢性疼痛不仅是相当大的经济负担，对患者来说也是相当大的个人负担。疼痛是生活质量差的最有力的预测因素之一，并且一直被发现与高抑郁率有关。尽管有大量的研究调查了哪些因素与慢性疼痛有关，但令人惊讶的是，很少有研究调查导致慢性疼痛的机制。慢性疼痛理论认为，心理特征增加了人们发展慢性疼痛的倾向。具体来说，理论认为，那些倾向于害怕疼痛的人会过度关注疼痛的感觉，避免引起疼痛的活动，因此有患慢性疼痛的风险。这项研究将检验这些理论。如果发现过度治疗疼痛确实使患者易患慢性疼痛，这将对预防慢性疼痛的发展具有重要意义。这些发现可能有助于设计早期干预措施，以预防慢性疾病，从而减轻保健服务的经济负担和患者在生活质量下降方面的情感负担。