Mallen Christian D, Mottram Sara, Thomas Elaine
Arthritis Research Campaign, National Primary Care Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK.
Soc Psychiatry Psychiatr Epidemiol. 2009 Jun;44(6):489-94. doi: 10.1007/s00127-008-0453-7. Epub 2008 Oct 30.
Depression is frequently associated with pain, yet the exact nature of this relationship is still not completely understood. Increasingly it is thought that pain and depression may share a common causal pathway that may originate in childhood.
A cross-sectional population-based survey recruited participants aged 18-25 years. Participants were asked about their current and childhood pain experiences. Current levels of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale.
A total of 858 young adults responded to the questionnaire. Depression was associated with having a family member with pain during childhood (OR 1.50; 95% CI 1.00, 2.26), having more illness than peers during secondary school (1.66; 1.03, 2.67) and having more than three relatives with pain during childhood (OR 2.48; 1.48, 4.15). Adult anxiety was associated with more illness than peers at primary school (1.73; 1.15, 2.61), more 'emotional' causes of pain at both primary (1.73; CI 1.13, 2.65) and secondary school (2.06; 1.41, 3.00), and having a family member with pain during childhood (1.39; 1.04, 1.86).
This study adds further evidence of an association between pain experiences in childhood and mental health problems in adulthood. Clinicians should be aware of the importance of assessing childhood pain exposures in adult patients with common mental health problems.
抑郁症常与疼痛相关,但这种关系的确切性质仍未完全明了。人们越来越认为,疼痛和抑郁症可能共享一条可能始于童年的共同因果途径。
一项基于人群的横断面调查招募了18至25岁的参与者。参与者被问及他们当前和童年时期的疼痛经历。使用医院焦虑抑郁量表评估当前的焦虑和抑郁水平。
共有858名年轻人回答了问卷。抑郁症与童年时期有家庭成员患有疼痛(比值比1.50;95%置信区间1.00, 2.26)、中学期间比同龄人患病更多(1.66;1.03, 2.67)以及童年时期有超过三个亲属患有疼痛(比值比2.48;1.48, 4.15)有关。成人焦虑与小学时比同龄人患病更多(1.73;1.15, 2.61)、小学(1.73;置信区间1.13, 2.65)和中学(2.06;1.41, 3.00)时更多“情感”性疼痛原因以及童年时期有家庭成员患有疼痛(1.39;1.04, 1.86)有关。
本研究进一步证明了童年时期的疼痛经历与成年期心理健康问题之间存在关联。临床医生应意识到在患有常见心理健康问题的成年患者中评估童年疼痛暴露情况的重要性。