Haythornthwaite Jennifer A, Sieber William J, Kerns Robert D
National Institute on Aging, Baltimore, MD 21224 U.S.A. Yale University, New Haven, CT 06520 U.S.A. Yale University School of Medicine and West Haven Veterans Affairs Medical Center, Psychology Service, West Haven, CT 06516 U.S.A.
Pain. 1991 Aug;46(2):177-184. doi: 10.1016/0304-3959(91)90073-7.
The present study examined the relationship between depression and a constellation of pain-related variables that describe the experience of chronic pain patients. Thirty-seven depressed and 32 non-depressed heterogeneous chronic pain patients were identified through structured interviews, use of standardized criteria and scores on the Beck Depression Inventory (BDI). The 2 groups were compared on demographic variables and scores on the Marlowe-Crowne Social Desirability scale (MC), as well as measures of disability and medication use, pain severity, interference due to pain and reported pain behaviors. The depressed group was found to be younger and to score lower on the MC than the non-depressed group. Multivariate analyses of covariance (MANCOVA), using age and MC as covariates, revealed that depressed chronic pain patients, relative to their non-depressed counterparts, reported greater pain intensity, greater interference due to pain and more pain behaviors. There were no group differences on the measures of disability and use of medications. The results provide further support for the importance of incorporating depression into clinical and theoretical formulations of chronic pain. Future use of structured interviews and standardized criteria for diagnosing depression may clarify some of the inconsistencies found in the literature.
本研究考察了抑郁症与一系列描述慢性疼痛患者经历的疼痛相关变量之间的关系。通过结构化访谈、使用标准化标准以及贝克抑郁量表(BDI)得分,确定了37名抑郁的和32名非抑郁的异质性慢性疼痛患者。对两组患者在人口统计学变量、马洛-克劳恩社会期望量表(MC)得分、残疾和药物使用情况、疼痛严重程度、疼痛干扰以及报告的疼痛行为等方面进行了比较。结果发现,抑郁组比非抑郁组年龄更小,且在MC量表上得分更低。以年龄和MC作为协变量进行的多变量协方差分析(MANCOVA)显示,与非抑郁的慢性疼痛患者相比,抑郁的慢性疼痛患者报告的疼痛强度更大、疼痛干扰更大且疼痛行为更多。在残疾和药物使用测量方面,两组之间没有差异。这些结果进一步支持了将抑郁症纳入慢性疼痛的临床和理论模型的重要性。未来使用结构化访谈和标准化标准来诊断抑郁症可能会澄清文献中发现的一些不一致之处。