McWilliams Lachlan A, Clara Ian P, Murphy Paul D J, Cox Brian J, Sareen Jitender
Department of Psychology, Acadia University, Wolfville, Nova Scotia, Canada.
J Pain. 2008 Jan;9(1):37-44. doi: 10.1016/j.jpain.2007.08.002. Epub 2007 Sep 24.
Data from the National Epidemiological Study of Alcoholism and Related Conditions (NESARC) were used to investigate associations between arthritis and a wide range of psychiatric disorders in a large sample (n = 43,093) representative of the adult population of the United States. NESARC participants completed the Alcohol Use Disorder and Associated Disabilities Interview Schedule--DSM-IV Version and provided reports regarding medical conditions, including arthritis, experienced over the past year. Logistic regression analyses that adjusted for potential confounding variables (ie, gender, marital status, age, income, and other health conditions) indicated that arthritis had significant positive associations with each of the 7 personality disorders included in the NESARC (ie, avoidant, dependent, obsessive-compulsive, paranoid, schizoid, histrionic, and antisocial). Arthritis also had significant positive associations with mood and anxiety disorders. In contrast to several recent studies indicating arthritis may have relatively larger associations with anxiety disorders than with major depression, the magnitudes of the associations involving anxiety disorders were not particularly large compared with those regarding depressive disorders. Alcohol- and substance-related disorders had negative associations with arthritis. However, additional analyses indicated that age was a confounding variable in these relationships and revealed that arthritis was not associated with either alcohol- or substance-related disorders.
This article presents the first study to investigate associations between arthritis and personality disorders and is the first study to investigate relationships between a condition characterized by pain and personality disorders using a community sample. It may prompt research and clinical attention to the role of personality disorders in arthritis.
来自全国酒精中毒及相关疾病流行病学研究（NESARC）的数据被用于在一个代表美国成年人口的大样本（n = 43,093）中调查关节炎与多种精神障碍之间的关联。NESARC的参与者完成了酒精使用障碍及相关残疾访谈表——DSM-IV版，并提供了关于包括关节炎在内的过去一年中所经历的医疗状况的报告。对潜在混杂变量（即性别、婚姻状况、年龄、收入和其他健康状况）进行调整后的逻辑回归分析表明，关节炎与NESARC中包含的7种人格障碍（即回避型、依赖型、强迫型、偏执型、分裂样、表演型和反社会型）中的每一种都有显著的正相关。关节炎与情绪和焦虑障碍也有显著的正相关。与最近几项表明关节炎与焦虑障碍的关联可能比与重度抑郁症的关联相对更大的研究相反，与涉及抑郁症的关联程度相比，涉及焦虑障碍的关联程度并不是特别大。酒精和物质相关障碍与关节炎呈负相关。然而，进一步的分析表明年龄是这些关系中的一个混杂变量，并揭示关节炎与酒精或物质相关障碍均无关联。
本文首次研究了关节炎与人格障碍之间的关联，也是首次使用社区样本研究一种以疼痛为特征的疾病与人格障碍之间的关系。它可能会促使人们对人格障碍在关节炎中的作用进行研究和临床关注。
