Katz Jennifer, McDermott Michael P, Cooper Edith M, Walther Robert R, Sweeney Eugene W, Dworkin Robert H
Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
J Pain. 2005 Dec;6(12):782-90. doi: 10.1016/j.jpain.2005.07.006.
The results of previous studies using retrospective methods or small samples have suggested that there may be psychosocial risk factors for postherpetic neuralgia (PHN). We conducted a prospective study in which 110 patients with herpes zoster were assessed within the first month after rash onset with measures of acute pain and five broad domains of psychosocial functioning-physical, role, social, and emotional functioning, and stress and social support. Twenty of the 102 patients with follow-up data were diagnosed with PHN, defined as pain that had persisted for 4 months after rash onset. Measures of role functioning, personality disorder symptoms, and disease conviction during herpes zoster each made independent contributions to predicting either presence or intensity of PHN in logistic and linear regression analyses that controlled for relevant demographic and clinical variables, including age and acute pain intensity. These findings indicate that psychosocial variables are risk factors for the development of PHN.
The results of this prospective study of patients with herpes zoster suggest that future research on the mechanisms and prevention of PHN should consider psychosocial as well as neurobiologic processes.
以往使用回顾性方法或小样本的研究结果表明，带状疱疹后神经痛（PHN）可能存在社会心理风险因素。我们进行了一项前瞻性研究，在皮疹发作后的第一个月内，对110例带状疱疹患者进行了评估，测量了急性疼痛以及社会心理功能的五个广泛领域——身体、角色、社会和情感功能，以及压力和社会支持。在102例有随访数据的患者中，20例被诊断为PHN，定义为皮疹发作后持续4个月的疼痛。在控制了包括年龄和急性疼痛强度在内的相关人口统计学和临床变量的逻辑回归和线性回归分析中，带状疱疹期间的角色功能、人格障碍症状和疾病信念测量值均对预测PHN的存在或强度做出了独立贡献。这些发现表明，社会心理变量是PHN发生的风险因素。
这项对带状疱疹患者的前瞻性研究结果表明，未来关于PHN机制和预防的研究应同时考虑社会心理过程和神经生物学过程。
