INSERM U-987, Boulogne-Billancourt F-92100, France CHU Ambroise Paré, APHP, Boulogne-Billancourt F-92100, France Université Versailles-Saint-Quentin, F-78035, France CHU Pasteur, Centre d'Evaluation et Traitement de la Douleur, Nice, F-06000 and INSERM U 929, Clermont-Ferrand 63000, France CHU de Bellevue, Service de Neurologie, Saint-Etienne F-42055, France Service de biostatistiques, Hôpital Necker, APHP, Paris F-75015, France.
Pain. 2011 Dec;152(12):2836-2843. doi: 10.1016/j.pain.2011.09.014. Epub 2011 Oct 20.
We report the first nationwide survey of the impact of neuropathic pain, as opposed to nonneuropathic pain, on quality of life and health care utilization in the French general population. A postal questionnaire was sent to a representative sample of 4554 respondents from an initial nationwide survey of 30,155 subjects with or without chronic pain. It included pain characteristics (Neuropathic Pain Symptom Inventory, DN4), quality of life (Medical Outcomes Short Form 12, SF-12), sleep, anxiety/depressive symptoms (Hospital Anxiety and Depression Scale) and health care utilization. In total, 3899 (85.6%) questionnaires were returned, 3816 (97.9%) could be assessed and 3165 subjects (82.9%) confirmed their pain status. Subjects reporting pain and neuropathic characteristics based on the DN4 displayed a higher degree of impairment of all dimensions relating to quality of life and sleep and had higher anxiety/depression scores than those reporting pain without neuropathic characteristics and those without pain (P<.01). They also made greater use of health care facilities, particularly as concerned neurological treatments and visits to neurologists (21% vs 9%; P<.01). Multivariate analyses showed that the neuropathic characteristics of pain made an independent contribution to quality-of-life impairment (P<.0001 and P=.0005 for the physical and mental scores of the SF-12 respectively). Our study indicates that the disease burden of chronic pain depends on the nature of the pain, independently of its intensity and duration.
我们报告了首次全国性调查,以了解神经病理性疼痛(与非神经病理性疼痛相反)对法国普通人群生活质量和医疗保健利用的影响。一项邮寄问卷调查了来自最初对 30155 名患有或不患有慢性疼痛的受试者进行的全国性调查的 4554 名代表性受访者。它包括疼痛特征(神经性疼痛症状量表,DN4)、生活质量(医疗结局短式 12 项量表,SF-12)、睡眠、焦虑/抑郁症状(医院焦虑和抑郁量表)和医疗保健利用情况。总共,3899 份(85.6%)问卷被退回,3816 份(97.9%)可进行评估,3165 名受试者(82.9%)确认了他们的疼痛状况。根据 DN4 报告疼痛和神经病理性特征的受试者在与生活质量和睡眠相关的所有维度上都表现出更高程度的损伤,并且焦虑/抑郁评分高于报告无神经病理性特征疼痛的受试者和无疼痛的受试者(P<.01)。他们也更多地利用医疗保健设施,特别是在神经科治疗和看神经科医生方面(21%比 9%;P<.01)。多变量分析表明,疼痛的神经病理性特征对生活质量受损有独立的影响(SF-12 的身体和心理评分分别为 P<.0001 和 P=.0005)。我们的研究表明,慢性疼痛的疾病负担取决于疼痛的性质,而与疼痛的强度和持续时间无关。