Bonnewyn A, Katona C, Bruffaerts R, Haro J M, de Graaf R, Alonso J, Demyttenaere K
University Psychiatric Center KuLeuven, Campus Gasthuisberg, Leuven, Belgium.
J Affect Disord. 2009 Oct;117(3):193-6. doi: 10.1016/j.jad.2009.01.012. Epub 2009 Feb 13.
Chronic pain and mood disorders are common in older people. Their relationship however remains unclear. Only a few studies have investigated the role of pain in mental health service use and received psychopharmacological treatment.
Cross-sectional study of the 65+ subsample from the European Study on the Epidemiology of Mental Disorders (ESEMeD). 4401 non-institutionalized individuals were interviewed using the third version of the Composite International Diagnostic Interview (CIDI-3.0).
Painful physical symptoms (PPS) were more likely in people with a 12-month major depressive episode (MDE) than in those without (OR=2.0). Help seeking for emotional problems was uncommon, but PPS were a significant predictor of help-seeking (OR=1.7). Respondents with MDE more frequently used benzodiazepines than antidepressants. The presence of PPS in respondents without depression resulted in a significant increase in the use of psychotropic medication.
PPS were strongly and independently associated with major depressive disorder. Their presence had an influence on help seeking behavior and use of psychotropic medication.
The cross-sectional nature of this study does not allow determination of direction of causality.
慢性疼痛和情绪障碍在老年人中很常见。然而，它们之间的关系仍不明确。只有少数研究调查了疼痛在使用心理健康服务和接受心理药物治疗方面的作用。
对欧洲精神障碍流行病学研究（ESEMeD）中65岁及以上的子样本进行横断面研究。使用综合国际诊断访谈第三版（CIDI-3.0）对4401名非机构化个体进行访谈。
与无12个月重度抑郁发作（MDE）的人相比，有12个月MDE的人出现疼痛性身体症状（PPS）的可能性更大（比值比[OR]=2.0）。因情绪问题寻求帮助的情况并不常见，但PPS是寻求帮助的一个重要预测因素（OR=1.7）。患有MDE的受访者使用苯二氮䓬类药物比使用抗抑郁药更频繁。无抑郁的受访者中存在PPS导致精神药物使用显著增加。
PPS与重度抑郁症密切且独立相关。它们的存在对寻求帮助行为和精神药物使用有影响。
本研究的横断面性质无法确定因果关系的方向。
