Smith Bruce W, Zautra Alex J
Department of Psychology, University of New Mexico, MSC03 2220, Albuquerque, NM 87131-1161, USA Department of Psychology, Arizona State University, PO Box 871104, Tempe, AZ 85287-1104, USA.
Pain. 2008 Aug 31;138(2):354-361. doi: 10.1016/j.pain.2008.01.008. Epub 2008 Mar 4.
This study examined the effects of anxiety and depression on pain in women with rheumatoid arthritis (RA; n=82) or osteoarthritis (OA; n=88). Anxiety and depression symptoms were assessed at the beginning of the study. Arthritis pain, interpersonal stress, negative affect, and positive affect were assessed weekly for 11 consecutive weeks. Multilevel analyses were conducted to investigate direct, indirect, and interactive effects of anxiety and depression on weekly changes in pain. When entered separately into the prediction equations, anxiety and depression were both related to elevations in current and next week pain, although the effects were nearly twice as large for anxiety. In addition, both anxiety and depression were indirectly related to current pain through negative and positive affect and depression interacted with stress to predict current pain in the RA group. When entered together into the prediction equations, anxiety alone was still related to elevations in current and next week pain. In addition, anxiety alone was indirectly related to current pain through negative affect and depression alone was indirectly related to current pain through positive affect. These results highlight the need for careful study of the differential effects of anxiety and depression and treatments that target their unique mechanisms.
本研究考察了焦虑和抑郁对类风湿关节炎（RA；n = 82）或骨关节炎（OA；n = 88）女性患者疼痛的影响。在研究开始时评估焦虑和抑郁症状。连续11周每周评估关节炎疼痛、人际压力、消极情绪和积极情绪。进行多层次分析以研究焦虑和抑郁对每周疼痛变化的直接、间接和交互作用。当分别纳入预测方程时，焦虑和抑郁均与当前及下周疼痛加剧有关，尽管焦虑的影响几乎是抑郁的两倍。此外，焦虑和抑郁均通过消极和积极情绪与当前疼痛间接相关，并且在类风湿关节炎组中，抑郁与压力相互作用以预测当前疼痛。当同时纳入预测方程时，仅焦虑仍与当前及下周疼痛加剧有关。此外，仅焦虑通过消极情绪与当前疼痛间接相关，仅抑郁通过积极情绪与当前疼痛间接相关。这些结果凸显了仔细研究焦虑和抑郁的差异效应以及针对其独特机制的治疗方法的必要性。
