Fröhlich Christine, Jacobi Frank, Wittchen Hans-Ulrich
Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany.
Eur Arch Psychiatry Clin Neurosci. 2006 Apr;256(3):187-96. doi: 10.1007/s00406-005-0625-3. Epub 2005 Nov 18.
Despite an abundance of questionnaire data, the prevalence of clinically significant and medically unexplained pain syndromes in the general population has rarely been examined with a rigid personal-interview methodology.
To examine the prevalence of pain syndromes and DSM-IV pain disorder in the general population and the association with other mental disorders, as well as effects on disability and health-care utilization.
Analyses were based on a community sample of 4.181 participants 18-65 years old; diagnostic variables were assessed with a standardized diagnostic interview (M-CIDI).
The 12-month prevalence for DSM-IV pain disorder in the general population was 8.1%; more than 53% showed concurrent anxiety and mood disorders. Subjects with pain disorder revealed significantly poorer quality of life, greater disability, and higher health-care utilization rates compared to cases with pain below the diagnostic threshold. The majority had more than one type of pain, with excessive headache being the most frequent type.
Even when stringent diagnostic criteria are used, pain disorder ranks among the most prevalent conditions in the community. The joint effects of high prevalence in all age groups, substantial disability, and increased health services utilization result in a substantial total burden, exceeding that of depression and anxiety.
尽管有大量问卷调查数据，但临床上显著且医学上无法解释的疼痛综合征在普通人群中的患病率很少通过严格的个人访谈方法进行研究。
研究普通人群中疼痛综合征和《精神疾病诊断与统计手册》第四版（DSM-IV）疼痛障碍的患病率，以及与其他精神障碍的关联，及其对残疾和医疗保健利用的影响。
分析基于一个由4181名18至65岁参与者组成的社区样本；诊断变量通过标准化诊断访谈（M-CIDI）进行评估。
普通人群中DSM-IV疼痛障碍的12个月患病率为8.1%；超过53%的人同时患有焦虑和情绪障碍。与诊断阈值以下疼痛的患者相比，患有疼痛障碍的患者生活质量明显较差、残疾程度更高且医疗保健利用率更高。大多数人有不止一种疼痛类型，其中过度头痛是最常见的类型。
即使使用严格的诊断标准，疼痛障碍在社区中也是最普遍的疾病之一。所有年龄组的高患病率、严重残疾以及医疗服务利用率增加的共同影响导致了巨大的总体负担，超过了抑郁症和焦虑症。
