Department of Psychiatry, University College Hospital, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Int Psychogeriatr. 2011 Aug;23(6):923-9. doi: 10.1017/S1041610210002322. Epub 2011 Jan 18.
Chronic pain is quite common in the elderly and is often associated with comorbid depression, limitation of functioning and reduced quality of life. The aim of this study was to ascertain whether there is a differential risk of depression among persons with pain in different anatomical sites and to determine which pain conditions are independent risk factors for depression.
Data are from the Ibadan Study of Ageing (ISA), a community-based longitudinal survey of persons aged 65 years and older from eight contiguous Yoruba-speaking states in Nigeria (n = 2152). Data were collected in face-to-face interviews; depression was assessed using the World Mental Health initiative version of the Composite International Diagnostic Interview (CIDI) while chronic pain was assessed by self-report (response rate = 74%).
Estimates of persistent pain (lasting more than six months), in different anatomical sites range from 1.3% to 12.8%, with the commonest being joint pains (12.8%), neck or back (spinal) pain (7.6%) and chest pain (3.0%). Significantly more pain conditions were reported by females and by respondents who were aged over 80 years. The risk for depression was higher in respondents with spinal, joint and chest pain. However, only chest pain was independently associated with depression after adjustments were made for pains at other sites and for functional disability.
Our data suggests that, among elderly persons, there is a differential association of depression with chronic pain that is related to the anatomical site of the pain.
慢性疼痛在老年人中很常见,常伴有共病抑郁、功能受限和生活质量下降。本研究旨在确定不同解剖部位疼痛患者的抑郁风险是否存在差异,并确定哪些疼痛状况是抑郁的独立危险因素。
数据来自伊巴丹老龄化研究(ISA),这是一项基于社区的、对来自尼日利亚八个相邻约鲁巴语州的 65 岁及以上人群进行的纵向调查(n=2152)。数据通过面对面访谈收集;抑郁使用世界心理健康倡议复合国际诊断访谈(CIDI)版本进行评估,而慢性疼痛则通过自我报告进行评估(应答率=74%)。
不同解剖部位持续疼痛(持续超过 6 个月)的估计发生率从 1.3%到 12.8%不等,最常见的是关节疼痛(12.8%)、颈部或背部(脊柱)疼痛(7.6%)和胸痛(3.0%)。女性和 80 岁以上的受访者报告的疼痛状况明显更多。脊柱、关节和胸痛患者发生抑郁的风险更高。然而,在调整了其他部位疼痛和功能障碍后,只有胸痛与抑郁独立相关。
我们的数据表明,在老年人中,抑郁与慢性疼痛之间存在差异,这种差异与疼痛的解剖部位有关。