Hoff Ahna L, Palermo Tonya M, Schluchter Mark, Zebracki Kathy, Drotar Dennis
Rainbow Babies and Children's Hospital, Case Western Reserve University, USA.
J Pediatr Psychol. 2006 Nov-Dec;31(10):1046-56. doi: 10.1093/jpepsy/jsj076. Epub 2005 Sep 8.
To examine the longitudinal relationship between depressive symptoms at study entry (T1) on pain intensity (PI) and functional disability over a 1-year period among children with either sickle cell disease (SCD) or juvenile idiopathic arthritis (JIA).
119 children, ages 8-17 years, completed measures of depression at T1 as well as pain and functional disability at T1, 6-month (T2), and 12-month (T3) follow-ups. Caregivers also rated their child's pain and disability at each time point. General linear mixed modeling was employed to examine longitudinal relationships between study variables.
For children with JIA, T1 pain significantly moderated the effects of T1-depressive symptoms on T2 and T3 pain where T1-depressive symptoms predicted future child-reported pain only when T1 pain was relatively mild. Similarly, T1-depressive symptoms predicted future child-reported disability only when initial reports of disability were relatively low. Only family income significantly predicted T2 and T3 pain in children with SCD.
Study findings suggest that T1-depressive symptoms play a role in the longitudinal course of pain symptoms in children with JIA but not in children with SCD.
研究镰状细胞病（SCD）或幼年特发性关节炎（JIA）患儿在研究开始时（T1）的抑郁症状与1年内疼痛强度（PI）和功能残疾之间的纵向关系。
119名8至17岁的儿童完成了T1时的抑郁测量以及T1、6个月（T2）和12个月（T3）随访时的疼痛和功能残疾测量。照顾者也对其孩子在每个时间点的疼痛和残疾情况进行了评分。采用一般线性混合模型来研究研究变量之间的纵向关系。
对于JIA患儿，T1疼痛显著调节了T1抑郁症状对T2和T3疼痛的影响，即只有当T1疼痛相对较轻时，T1抑郁症状才预测未来儿童报告的疼痛。同样，只有当最初报告的残疾程度相对较低时，T1抑郁症状才预测未来儿童报告的残疾。只有家庭收入显著预测了SCD患儿的T2和T3疼痛。
研究结果表明，T1抑郁症状在JIA患儿疼痛症状的纵向病程中起作用，但在SCD患儿中不起作用。
