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长期患有纤维肌痛症的病假员工:将他们的多学科评估特征与其他患有慢性疼痛疾病和抑郁症的患者进行比较。

Long-term sick-leavers with fibromyalgia: Comparing their multidisciplinarily assessed characteristics with those of others with chronic pain conditions and depression.

机构信息

Diagnostic Centre, Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;

出版信息

J Multidiscip Healthc. 2009 Jan 21;2:23-37. doi: 10.2147/jmdh.s4659.

Abstract

OBJECTIVE

The aim was to gain knowledge of fibromyalgia (FM) patients on long-term sick leave and with particular difficulties in resuming work, and to compare them with patients with myalgia, back or joint diagnoses, and depression.

METHODS

Patients were identified by and referred from social insurance offices and were multidisciplinarily examined by three board-certified specialists in psychiatry, orthopedic surgery and rehabilitation medicine. Ninety-two women were diagnosed with FM only. Three female comparison groups were chosen: depression, back/joint diagnoses, and myalgia.

RESULTS AND CONCLUSIONS

Ceaseless pain was reported by 73% of FM patients, 54% of back/joint diagnoses patients, 43% of myalgia patients, and 35% of depression patients. The distribution of pain (>50%) in FM patients was to almost all regions of the body, and in depression patients to the lower dorsal neck, upper shoulders and lumbosacral back but not in the anterior body. Reduced sleep was more evident in FM patients. FM patients did not meet more criteria for personality disorder than patients with the other somatic pain conditions. The most common dimension of "personality traits" of somatic pain conditions was the "obsessive compulsive" but at a level clearly below that indicating a personality disorder. More FM patients experienced disabilities, the most common being in the mobility and domestic-life areas.

摘要

目的

了解长期请病假且重返工作岗位困难较大的纤维肌痛(FM)患者,并将其与患有肌痛、背部或关节疾病和抑郁症的患者进行比较。

方法

通过社会保险办公室识别并转介患者,并由三位经过认证的精神病学、矫形外科和康复医学专家进行多学科检查。92 名女性被诊断为仅患有 FM。选择了三个女性对照组:抑郁症、背部/关节疾病和肌痛。

结果和结论

73%的 FM 患者报告持续疼痛,54%的背部/关节疾病患者,43%的肌痛患者,35%的抑郁症患者。FM 患者的疼痛分布(>50%)几乎遍及全身,而抑郁症患者的疼痛分布在颈下部、肩部上部和腰骶部,但不在前体。FM 患者的睡眠质量下降更为明显。FM 患者的人格障碍标准并不比其他躯体疼痛疾病患者更多。躯体疼痛疾病“人格特质”最常见的维度是“强迫性”,但明显低于人格障碍的水平。更多的 FM 患者出现残疾,最常见的是在行动和日常生活方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21b2/3004556/8bc779448d90/jmdh-2-023f1.jpg

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