Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94303, USA.
J Psychiatr Res. 2010 May;44(7):454-61. doi: 10.1016/j.jpsychires.2009.10.013. Epub 2010 Feb 9.
This study aims (1) to assess the prevalence of Chronic Painful Physical Condition (CPPC) and major depressive disorder (MDD) in the general population; (2) to evaluate their interaction and co-morbidity with sleep and organic disorders; and (3) to investigate their daily functioning and socio-professional consequences. A random sample of 3243 subjects (18years), representative of California inhabitants, was interviewed by telephone. CPPC duration was at least 6months. Frequency, severity, duration and consequences on daily functioning, consultations, sick leave and treatment were investigated. MDD were assessed using DSM-IV criteria. The point prevalence of CPPC was 49% (95% confidence interval: 47.0-51.0%). Back area pain was the most frequent; 1-month prevalence of MDD was at 6.3% (95% CI: 5.5-7.2%); 66.3% of MDD subjects reported at least one CPPC. In 57.1% of cases, pain appeared before MDD. Pain severity was increased by poor sleep, stress and tiredness in MDD subjects. Being confined to bed, taking sick leave and interference of pain with daily functioning were twice as frequent among MDD subjects with CPPC than in non-MDD subjects with CPPC; obese individuals with CP were 2.6 times as likely to have MDD. Pain is highly linked with depressive disorder. It deteriorates physical, occupational and socio-professional activities. Pain and sleep disturbances are a prime motive of consultation rather than depressed mood, underlining the risk of missing a depression diagnosis.
(1)评估普通人群中慢性疼痛性躯体疾病（CPPC）和重度抑郁障碍（MDD）的患病率；(2)评估它们与睡眠和器质性疾病的相互作用和共病关系；(3)研究它们的日常功能和社会职业后果。通过电话对 3243 名（18 岁）具有代表性的加利福尼亚居民进行了随机抽样调查。CPPC 的持续时间至少为 6 个月。调查了疼痛的频率、严重程度、持续时间及其对日常功能、就诊、病假和治疗的影响。使用 DSM-IV 标准评估 MDD。CPPC 的时点患病率为 49%（95%置信区间：47.0-51.0%）。腰背区疼痛最常见；1 个月的 MDD 患病率为 6.3%（95%CI：5.5-7.2%）；66.3%的 MDD 患者报告至少有一种 CPPC。在 57.1%的病例中，疼痛先于 MDD 出现。在 MDD 患者中，睡眠不佳、压力大和疲劳会加重疼痛。与非 MDD 伴 CPPC 患者相比，MDD 伴 CPPC 患者卧床、请病假和疼痛对日常功能的干扰更为频繁；CP 肥胖者患 MDD 的可能性是 CP 非肥胖者的 2.6 倍。疼痛与抑郁障碍高度相关。它会使身体、职业和社会职业活动恶化。疼痛和睡眠障碍是就诊的主要原因，而不是抑郁情绪，这突出了漏诊抑郁的风险。
