Department of Psychiatry, Loma Linda University School of Medicine, Loma Linda, California 92350, USA.
Pain Med. 2010 Nov;11(11):1698-706. doi: 10.1111/j.1526-4637.2010.00988.x.
To identify correlates of perceived pain-related restrictions in a community sample of women with fibromyalgia.
The fibromyalgia group was composed of white women with a self-reported, physician-given fibromyalgia diagnosis (N = 238) from the Biopsychosocial Religion and Health Study (BRHS). BRHS respondents had participated in the larger Adventist Health Study-2. To identify associations with pain-related restrictions, we used hierarchical linear regression. The outcome measure was subjects' pain-related restrictions (one SF-12 version 2 item). Predictors included age, education, body mass index (BMI), sleep apnea, and fibromyalgia treatment in the last year, as well as standardized measures for trauma, major life stress, depression, and hostility. To better interpret the findings, pain-related restrictions also were predicted in women with osteoarthritis and no fibromyalgia.
Women with fibromyalgia reporting the more severe pain-related restrictions were those who had experienced trauma accompanied by physical pain, were older, less educated, more depressed, more hostile, had high BMI scores, and had been treated for fibromyalgia in the last 12 months (adjusted R(2) = 0.308). Predictors in women with osteoarthritis were age, BMI, treatment in the last 12 months, experience of a major life stressor, and greater depression symptom severity (adjusted R(2) = 0.192).
In both groups, age, BMI, treatment in the last 12 months, and depression predicted pain-related restrictions. Experience of a traumatic event with physical pain was the strongest predictor in the fibromyalgia group. These findings may be useful in constructing novel treatments and prevention strategies for pain-related morbidity in fibromyalgia patients.
在纤维肌痛症的女性社区样本中,确定感知疼痛相关限制的相关因素。
纤维肌痛症组由来自生物心理社会宗教与健康研究(BRHS)的自我报告、医生诊断的患有纤维肌痛症的白人女性组成(N=238)。BRHS 受访者参加了更大的 Adventist Health Study-2。为了确定与疼痛相关限制的关联,我们使用了分层线性回归。因变量是受试者的疼痛相关限制(SF-12 版本 2 中的一个项目)。预测因素包括年龄、教育程度、体重指数(BMI)、睡眠呼吸暂停以及过去一年的纤维肌痛症治疗,以及创伤、重大生活压力、抑郁和敌意的标准化测量。为了更好地解释发现,还预测了患有骨关节炎且无纤维肌痛症的女性的疼痛相关限制。
报告疼痛相关限制更严重的纤维肌痛症女性是那些经历过伴有身体疼痛的创伤、年龄较大、受教育程度较低、抑郁程度较高、敌意较强、BMI 得分较高以及过去 12 个月接受过纤维肌痛症治疗的女性(调整后的 R²=0.308)。骨关节炎女性的预测因素是年龄、BMI、过去 12 个月的治疗、重大生活压力源的经历以及更严重的抑郁症状严重程度(调整后的 R²=0.192)。
在两组中,年龄、BMI、过去 12 个月的治疗以及抑郁都预测了疼痛相关限制。伴有身体疼痛的创伤经历是纤维肌痛症组中最强的预测因素。这些发现可能有助于为纤维肌痛症患者的疼痛相关发病率构建新的治疗和预防策略。