Epidemiology Group, University of Aberdeen, School of Medicine and Dentistry, Polwarth Building, Foresterhill, Aberdeen, UK.
Rheumatology (Oxford). 2010 Oct;49(10):1882-8. doi: 10.1093/rheumatology/keq052. Epub 2010 Mar 9.
To determine whether childhood behaviour is associated with the likelihood of chronic widespread pain (CWP) in adulthood, and any such relationship is mediated through adult psychological distress, using a large population-based birth cohort.
A prospective cohort study (the 1958 British Birth Cohort) was conducted. Participants were enrolled at birth in 1958, and followed up throughout childhood and adulthood. Data on childhood behaviour were collected from parents and teachers. Data regarding pain were collected at the age of 45 years by self-completion questionnaire. Risk ratios (RRs) and 95% CIs were estimated using Poisson regression, adjusting for gender, social class in childhood and adulthood, childhood common symptoms and adult psychological distress.
CWP was slightly more common in adult females than males (12.9 vs 11.7%). There was an increased likelihood of reporting CWP at the age of 45 years with every unit increase in teacher-reported behaviour score at 16 (RR 1.04; 95% CI 1.02, 1.05), 11(RR 1.02; 95% CI 1.01, 1.03) and 7 years (RR 1.01; 95% CI 1.00, 1.02) of age. Those with scores indicating severe behaviour disturbances at 11 and 16 years of age had an increased likelihood of CWP in adulthood (RR 1.95; 95% CI 1.47, 2.59 and RR 1.69; 95% CI 1.18, 2.42, respectively). The strongest association was seen among those indicating persistent behaviour problems at 7, 11 and 16 years (RR 2.14; 95% CI 1.43, 3.21) of age, compared with those without at all three ages. Similar but slightly weaker associations were shown for parent-reported behaviour.
Maladjusted (social) behaviour is associated with increased long-term CWP beyond childhood and adolescence.
利用大型基于人群的出生队列,确定儿童行为是否与成年后慢性广泛性疼痛(CWP)的发生相关,以及这种相关性是否通过成人心理困扰来介导。
进行了一项前瞻性队列研究(1958 年英国出生队列)。参与者于 1958 年出生时入组,并在整个儿童期和成年期进行随访。从父母和教师那里收集儿童行为数据。在 45 岁时通过自我完成问卷收集有关疼痛的数据。使用泊松回归估计风险比(RR)和 95%置信区间,调整性别、儿童期和成年期的社会阶层、儿童期常见症状和成人心理困扰。
成年女性的 CWP 略高于男性(12.9%比 11.7%)。在 45 岁时报告 CWP 的可能性随着教师报告的 16 岁(RR 1.04;95%CI 1.02,1.05)、11 岁(RR 1.02;95%CI 1.01,1.03)和 7 岁(RR 1.01;95%CI 1.00,1.02)时行为得分增加而增加。在 11 岁和 16 岁时得分表明严重行为障碍的人在成年后 CWP 的可能性增加(RR 1.95;95%CI 1.47,2.59 和 RR 1.69;95%CI 1.18,2.42,分别)。在那些在 7、11 和 16 岁(RR 2.14;95%CI 1.43,3.21)时表明持续存在行为问题的人中,与在所有三个年龄段都没有的人相比,关联最强。父母报告的行为也显示出类似但稍弱的关联。
未经调整(社会)行为与儿童期和青春期后长期 CWP 的增加相关。