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纤维肌痛患者的日常情感关系显示出积极情感障碍。

Daily affect relations in fibromyalgia patients reveal positive affective disturbance.

作者信息

Finan Patrick H, Zautra Alex J, Davis Mary C

机构信息

Department of Psychology, Arizona State University, 950 S. McAllister, Tempe, AZ 85287-1104, USA.

出版信息

Psychosom Med. 2009 May;71(4):474-82. doi: 10.1097/PSY.0b013e31819e0a8b. Epub 2009 Feb 27.

Abstract

OBJECTIVES

To examine daily positive affective disturbance in the context of negative affect (NA) and pain among patients with fibromyalgia (FM) to determine a) if FM patients experience a deficit in daily positive affect (PA) relative to osteoarthritis (OA) patients; b) if FM patients differ from OA patients in the day-to-day relations of PA and NA; and c) if patients diagnosed with both OA and FM differ from patients with either OA-only or FM-only with respect to major outcomes.

METHODS

A total of 260 women with physician-diagnosed OA (n = 106), FM (n = 53), or OA/FM (n = 101) completed a 30-day electronic diary. Participants were assessed once daily on levels of PA, NA, and pain.

RESULTS

Multilevel models indicated that FM patients had less overall PA than OA patients and exhibited a stronger inverse PA-NA relation. Analyses further suggest that the OA/FM group may have been the most impaired of the three included in our study. This group was responsible for a lagged effect of PA on both affects, whereby high PA days resulted in low next-day PA and high next-day NA.

CONCLUSION

FM patients exhibit a PA disturbance compared with OA patients. This disturbance is reflected by an overall deficit in PA and an inability to sustain PA in the face of pain and NA. Patients with both OA and FM may represent a subgroup of FM that is at particular risk for dysregulation of PA.

摘要

目的

在纤维肌痛(FM)患者的负性情绪(NA)和疼痛背景下,研究每日的正性情绪干扰,以确定:a)相对于骨关节炎(OA)患者,FM患者在每日正性情绪(PA)方面是否存在缺陷;b)FM患者与OA患者在PA和NA的日常关系上是否存在差异;c)同时诊断为OA和FM的患者在主要结局方面与仅患OA或仅患FM的患者是否存在差异。

方法

共有260名经医生诊断为OA(n = 106)、FM(n = 53)或OA/FM(n = 101)的女性完成了一份为期30天的电子日记。参与者每天接受一次PA、NA和疼痛水平的评估。

结果

多水平模型表明,FM患者的总体PA低于OA患者,并且表现出更强的PA-NA负相关关系。分析进一步表明,OA/FM组可能是我们研究中所纳入的三组中受损最严重的。该组导致了PA对两种情绪的滞后效应,即PA值高的日子会导致次日PA值低以及次日NA值高。

结论

与OA患者相比,FM患者表现出PA干扰。这种干扰表现为PA总体不足,以及在面对疼痛和NA时无法维持PA。同时患有OA和FM的患者可能代表FM的一个亚组,该亚组在PA调节异常方面具有特别的风险。

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