Begré Stefan, Traber Martin, Gerber Martin, von Känel Roland
Klinik für Allgemeine Innere Medizin, Kompetenzbereich für Psychosomatische Medizin, Inselspital, Universitätsspital Bern, Bern, Schweiz.
Med Klin (Munich). 2010 Jun;105(6):393-8. doi: 10.1007/s00063-010-1070-2. Epub 2010 Jun 26.
Only few studies considered demographic and medical characteristics of pain patients with depressive symptoms.
The present study is a cross-sectional observation of 585 patients suffering from chronic pain and depressive symptoms from all over Switzerland who got an antidepressant treatment in 122 medical practices (internal medicine, general medicine, psychiatry). Based on their clinical experience within the Swiss mental health system, the authors hypothesized that internists and general practitioners, compared to psychiatrists, treat older and less depressive patients with less intense chronic pain and with regional origin from Central Europe.
In accordance with this hypothesis, internists (and general practitioners), compared to psychiatrists, more frequently provided care for older patients from Central Europe with less severe depressive symptoms and lower pain intensity and less head pain. Furthermore, compared with Central European patients, those patients from Eastern and Southern Europe presented more intense overall pain mainly affecting the head, extremities, back, and thorax whereas Southern Europeans tended to suffer even more frequently from chest pain compared with their Central European peers.
The study design pragmatically represents the caring situation for depressed patients with chronic pain in Switzerland regarding regional origin and pain intensity. The results are based on a respectable sample size recruited from all Swiss regions and by the physician specialities primarily involved in long-term management of this patient group.
仅有少数研究考虑了伴有抑郁症状的疼痛患者的人口统计学和医学特征。
本研究是一项横断面观察研究,纳入了来自瑞士各地的585例患有慢性疼痛和抑郁症状且在122家医疗机构(内科、普通科、精神科)接受抗抑郁治疗的患者。基于他们在瑞士心理健康系统中的临床经验,作者推测与精神科医生相比,内科医生和全科医生治疗的患者年龄更大、抑郁程度更低、慢性疼痛强度更低且来自中欧地区。
与该假设一致,与精神科医生相比,内科医生(和全科医生)更频繁地为来自中欧的老年患者提供治疗,这些患者抑郁症状较轻、疼痛强度较低且头痛较少。此外,与中欧患者相比,来自东欧和南欧的患者总体疼痛更强烈,主要影响头部、四肢、背部和胸部,而与中欧同龄人相比,南欧人胸痛更为频繁。
该研究设计切实反映了瑞士慢性疼痛抑郁症患者在地区来源和疼痛强度方面的护理情况。结果基于从瑞士所有地区招募的可观样本量,以及主要参与该患者群体长期管理的医生专业。