Psychiatry Department, University Hospital 12 de Octubre, Complutense University, Madrid & Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
J Affect Disord. 2011 Apr;130(1-2):106-12. doi: 10.1016/j.jad.2010.10.022. Epub 2010 Nov 4.
The need to assess the prevalence and characteristics of painful symptoms among depressed patients attended by psychiatrists in their regular clinical practice.
A multi-centre, cross-sectional study was carried out in a large sample (n=3566) of patients attending out-patient psychiatric facilities in Spain. All types of DSM-IV-TR depressive disorders were included. Data on the diagnosis, specific symptoms, intensity of depression and antidepressant and analgesic drug treatments were collected. The presence and characteristics of significant pain (visual analogue scale score>40) at the time of the study were also recorded.
The prevalence of pain in depressed patients was 59.1% (CI 95%: 57.7%; 60.7%). Factors associated independently with the existence of significant pain were: being female, presence of loss of energy and the diagnosis of dysthymia or depression induced by physical disorders. In addition, age and the intensity of depression were two risk factors, where each year of age and each point in the Hamilton scale increased the risk of having pain by 2% and 8% respectively. The presence of anhedonia and the diagnosis of depression induced by illegal drugs were factors inversely related to pain.
The cross-sectional naturalistic characteristics of the study.
Our data show a high prevalence of pain among depressive patients attending psychiatric clinics. Painful symptoms are modulated differently depending on the type of depression and the presence of specific symptoms, such as loss of energy or anhedonia. Psychiatrists should ask their depressive patients for the presence of pain on a regular basis.
需要评估在精神科医生常规临床实践中就诊的抑郁患者疼痛症状的患病率和特征。
在西班牙的一个大型样本（n=3566）门诊精神科设施就诊的患者中进行了一项多中心、横断面研究。包括所有类型的 DSM-IV-TR 抑郁障碍。收集了诊断、特定症状、抑郁严重程度以及抗抑郁药和镇痛药治疗的数据。还记录了研究时存在的显著疼痛（视觉模拟评分>40）的存在和特征。
抑郁患者的疼痛患病率为 59.1%（置信区间 95%：57.7%；60.7%）。与存在显著疼痛独立相关的因素有：女性、丧失活力、心境恶劣或由躯体障碍引起的抑郁症的诊断。此外，年龄和抑郁严重程度是两个危险因素，年龄每增加 1 岁，汉密尔顿量表增加 1 分，疼痛风险分别增加 2%和 8%。快感缺失的存在和由非法药物引起的抑郁症的诊断是与疼痛相关的反相关因素。
研究的横断面自然主义特征。
我们的数据显示，在精神科诊所就诊的抑郁患者中疼痛的患病率很高。疼痛症状的调节因抑郁类型和特定症状（如乏力或快感缺失）的存在而有所不同。精神科医生应定期询问他们的抑郁患者是否存在疼痛。
