撒哈拉以南非洲农村地区的背痛和颈痛与精神病理学：来自埃塞俄比亚吉尔吉尔吉贝生长与发育研究的证据
Back and neck pain and psychopathology in rural sub-Saharan Africa: evidence from the Gilgel Gibe Growth and Development Study, Ethiopia.
作者信息
El-Sayed Abdulrahman M, Hadley Craig, Tessema Fasil, Tegegn Ayalew, Cowan John A, Galea Sandro
机构信息
From the *Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan, Ann Arbor, MI; †University of Michigan Medical School, Ann Arbor, MI; ‡Department of Anthropology, Emory University, Atlanta, GA; §Jimma University, Jimma, Ethiopia; ¶Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI; ∥Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI; and **Center for Global Health, University of Michigan, Ann Arbor, MI.
出版信息
Spine (Phila Pa 1976). 2010 Mar 15;35(6):684-9. doi: 10.1097/BRS.0b013e3181b4926e.
STUDY DESIGN
Community-based cross-sectional analysis of the relation between symptoms of psychopathology and back pain (BP) or neck pain (NP) in rural southwest Ethiopia.
OBJECTIVE
Using data from a community-based sample, we assessed the prevalence and psychopathologic correlates of BP or NP in rural sub-Saharan Africa.
SUMMARY OF BACKGROUND DATA
BP and NP are among the most prevalent pain conditions. Psychopathology has been shown to be associated with both BP and NP in developed and urban developing contexts. Little is known about the relation between psychopathology and BP or NP in the rural, developing context.
METHODS
Data on self-reported BP and NP, symptoms of depression, anxiety, and post-traumatic stress (PTS), gender, age, and socioeconomic status were collected from a representative cohort sample (N = 900) in rural southwest Ethiopia. We calculated univariate statistics to assess the prevalence of BP and NP. We used bivariate χ2 tests and multivariate logistic regression models to assess the relation between psychopathology and BP and NP.
RESULTS
The prevalence of BP was 16.7%; that of NP was 5.0%. In χ2 analyses, symptoms of depression, anxiety, and PTS were significantly associated with increased risk for each outcome. In models adjusted for age, household assets, and gender, depression symptomatology was associated with increased risk for BP (OR = 3.44, 95% CI: 2.37-5.00) and NP (OR = 4.92, 95% CI: 2.49-9.74). Anxiety symptomatology was also associated with increased risk for BP (OR = 2.88, 95% CI: 1.98-4.20) and NP (OR = 2.67, 95% CI: 1.41-5.09). PTS symptomatology was associated with increased risk for BP (OR = 2.89, 95% CI: 1.78-4.69).
CONCLUSION
In the first known study about the relation between psychopathologic symptomatology and BP and NP in a rural context in a developing country, the prevalence of BP and NP were comparable to published data in developed and developing countries. Symptoms of depression and anxiety were correlates of BP and NP, and symptoms of PTS were a correlate of BP. Comparative studies about the relation between psychopathology and chronic pain conditions between rural and urban contexts in the global south are needed.
研究设计
对埃塞俄比亚西南部农村地区精神病理学症状与背痛（BP）或颈痛（NP）之间的关系进行基于社区的横断面分析。
目的
利用基于社区样本的数据，我们评估了撒哈拉以南非洲农村地区BP或NP的患病率及其精神病理学相关因素。
背景数据总结
BP和NP是最常见的疼痛病症。在发达国家和城市发展中地区，精神病理学已被证明与BP和NP均有关联。在农村发展中环境下，关于精神病理学与BP或NP之间的关系知之甚少。
方法
从埃塞俄比亚西南部农村地区具有代表性的队列样本（N = 900）中收集了关于自我报告的BP和NP、抑郁、焦虑和创伤后应激（PTS）症状、性别、年龄及社会经济地位的数据。我们计算单变量统计量以评估BP和NP的患病率。我们使用双变量χ2检验和多变量逻辑回归模型来评估精神病理学与BP和NP之间的关系。
结果
BP的患病率为16.7%；NP的患病率为5.0%。在χ2分析中，抑郁、焦虑和PTS症状与每种结果的风险增加显著相关。在对年龄、家庭资产和性别进行调整的模型中，抑郁症状与BP风险增加相关（比值比[OR] = 3.44，95%置信区间[CI]：2.37 - 5.00）以及与NP风险增加相关（OR = 4.92，95% CI：2.49 - 9.74）。焦虑症状也与BP风险增加相关（OR = 2.88，95% CI：1.98 - 4.20）以及与NP风险增加相关（OR = 2.67，95% CI：1.41 - 5.09）。PTS症状与BP风险增加相关（OR = 2.89，95% CI：1.78 - 4.69）。
结论
在关于发展中国家农村地区精神病理学症状与BP和NP之间关系的首个已知研究中，BP和NP的患病率与发达国家和发展中国家已发表的数据相当。抑郁和焦虑症状是BP和NP的相关因素，而PTS症状是BP的相关因素。需要对全球南方农村和城市环境中精神病理学与慢性疼痛病症之间的关系进行比较研究。
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