Johnson Kay M, Bradley Katharine A, Bush Kristen, Gardella Carolyn, Dobie Dorcas J, Laya Mary B
Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA.
J Gen Intern Med. 2006 Mar;21 Suppl 3(Suppl 3):S70-5. doi: 10.1111/j.1525-1497.2006.00378.x.
To determine the prevalence and frequency of mastalgia and its association with psychiatric conditions and unexplained pain syndromes.
DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional mailed survey completed by 1,219 female veterans enrolled at the VA Puget Sound Health Care System in 1998.
Breast pain in the past year, unrelated to pregnancy, was categorized as infrequent (< or =monthly) or frequent (> or =weekly) mastalgia. Surveys assessed posttraumatic stress disorder (PTSD), depression, panic disorder, and alcohol misuse with validated screening tests, as well as self-reported past-year chronic pelvic pain, fibromyalgia, and irritable bowel syndrome.
The response rate was 63%. Fifty-five percent of the respondents reported past-year mastalgia. Of these, 15% reported frequent mastalgia. Compared to women without mastalgia, women reporting frequent mastalgia were more likely to screen positive for PTSD (odds ratio [OR] 5.2, 95% confidence interval [CI] 3.2 to 8.4), major depression (OR 4.2, 2.6 to 6.9), panic disorder (OR 7.1, 3.9 to 12.8), eating disorder (OR 2.6, 1.5 to 4.7), alcohol misuse (OR 1.8, 1.1 to 2.8), or domestic violence (OR 3.1, 1.9 to 5.0), and to report fibromyalgia (OR 3.9, 2.1 to 7.4), chronic pelvic pain (OR 5.4, 2.7 to 10.5), or irritable bowel syndrome (OR 2.8, 1.6 to 4.8). Women with infrequent mastalgia were also more likely than women without mastalgia to screen positive for PTSD, depression, or panic disorder, or report pelvic pain or irritable bowel syndrome, although associations were weaker than with frequent mastalgia.
Like other unexplained pain syndromes, frequent mastalgia is strongly associated with PTSD and other psychiatric conditions. Clinicians seeing patients with frequent mastalgia should inquire about anxiety, depression, alcohol misuse, and trauma history.
确定乳房疼痛的患病率、发生频率及其与精神疾病和不明原因疼痛综合征的关联。
设计、研究地点和参与者：1998年在普吉特海湾退伍军人事务部医疗保健系统登记的1219名女性退伍军人完成的横断面邮寄调查。
过去一年中与妊娠无关的乳房疼痛被分类为偶发性（每月≤1次）或频发性（每周≥1次）乳房疼痛。调查通过有效的筛查测试评估创伤后应激障碍（PTSD）、抑郁症、惊恐障碍和酒精滥用情况，以及自我报告的过去一年慢性盆腔疼痛、纤维肌痛和肠易激综合征。
回复率为63%。55%的受访者报告过去一年有乳房疼痛。其中，15%报告频发乳房疼痛。与无乳房疼痛的女性相比，报告频发乳房疼痛的女性更有可能PTSD筛查呈阳性（优势比[OR]5.2，95%置信区间[CI]3.2至8.4）、重度抑郁症（OR 4.2，2.6至6.9）、惊恐障碍（OR 7.1，3.9至12.8）、饮食失调（OR 2.6，1.5至4.7）、酒精滥用（OR 1.8，1.1至2.8）或家庭暴力（OR 3.1，1.9至5.0），并报告纤维肌痛（OR 3.9，2.1至7.4）、慢性盆腔疼痛（OR 5.4，2.7至10.5）或肠易激综合征（OR 2.8，1.6至4.8）。偶发性乳房疼痛的女性与无乳房疼痛的女性相比，也更有可能PTSD、抑郁症或惊恐障碍筛查呈阳性，或报告盆腔疼痛或肠易激综合征，尽管关联程度比频发乳房疼痛的女性弱。
与其他不明原因疼痛综合征一样，频发乳房疼痛与PTSD和其他精神疾病密切相关。诊治频发乳房疼痛患者的临床医生应询问焦虑、抑郁、酒精滥用和创伤史。
