Gureje Oye, Von Korff Michael, Kola Lola, Demyttenaere Koen, He Yanling, Posada-Villa José, Lepine Jean Pierre, Angermeyer Matthias C, Levinson Daphna, de Girolamo Giovanni, Iwata Noboru, Karam Aimee, Guimaraes Borges Guilherme Luiz, de Graaf Ron, Browne Mark Oakley, Stein Dan J, Haro Josep Maria, Bromet Evelyn J, Kessler Ron C, Alonso Jordi
Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.
Pain. 2008 Mar;135(1-2):82-91. doi: 10.1016/j.pain.2007.05.005. Epub 2007 Jun 13.
It is unclear whether differences exist in the prevalence of mood, anxiety and alcohol use disorders among persons with multiple pain conditions compared with those with single pain problems. We conducted population surveys in 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific. Participants were community-dwelling adults (N=85,088). Mental disorders were assessed with the Composite International Diagnostic Interview. Pain was assessed by self-report. Both multiple and single site pain problems were associated with mood and anxiety disorders, but not with alcohol abuse or dependence. In general, the prevalence of specific mood and anxiety disorders followed a linear pattern with the lowest rates found among persons with no pain, intermediate rates among those with one pain, and highest rates among those with multi-site pain problems. Relative to persons not reporting pain, the pooled estimates of the age-sex adjusted odds ratios were 1.8 (1.7-2.0) for mood disorders and 1.9 (1.8-2.1) for anxiety disorders for persons with single site pain; 3.7 (3.3-4.1) for mood disorders and 3.6 (3.3-4.0) for anxiety disorders among those with multi-site pain. Our results indicate that the presence of multiple pain conditions was strongly and comparably associated with mood and anxiety disorders in diverse cultures. This consistent pattern of associations suggests that diffuse pain and psychiatric disorders are generally associated, rather than diffuse pain representing an idiom for expressing distress that is specific to particular cultural settings or diffuse pain solely representing a form of masked depression.
与患有单一疼痛问题的人相比，患有多种疼痛病症的人在情绪、焦虑和酒精使用障碍的患病率上是否存在差异尚不清楚。我们在欧洲、美洲、中东、非洲、亚洲和南太平洋的17个国家进行了人口调查。参与者为居住在社区的成年人（N = 85,088）。使用综合国际诊断访谈评估精神障碍。通过自我报告评估疼痛。多部位和单部位疼痛问题均与情绪和焦虑障碍相关，但与酒精滥用或依赖无关。一般来说，特定情绪和焦虑障碍的患病率呈线性模式，在无疼痛的人群中患病率最低，在有一处疼痛的人群中患病率中等，在有多部位疼痛问题的人群中患病率最高。相对于未报告疼痛的人，单部位疼痛患者情绪障碍的年龄性别调整优势比合并估计值为1.8（1.7 - 2.0），焦虑障碍为1.9（1.8 - 2.1）；多部位疼痛患者情绪障碍为3.7（3.3 - 4.1），焦虑障碍为3.6（3.3 - 4.0）。我们的结果表明，在不同文化中，多种疼痛病症的存在与情绪和焦虑障碍密切且相当相关。这种一致的关联模式表明，弥漫性疼痛和精神障碍通常相关，而不是弥漫性疼痛代表特定文化背景下表达痛苦的习语，或者弥漫性疼痛仅仅代表一种隐蔽性抑郁症的形式。
