Department of Psychosomatic Medicine, University Regensburg, Regensburg, Germany Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany Department of Anesthesiology, Hospital Weiden, Weiden, Germany Department of Neurology, Hospital Weiden, Weiden, Germany Department of Psychosomatic Medicine, Technische Universitaet München, München, Germany.
Pain. 2012 Jan;153(1):197-202. doi: 10.1016/j.pain.2011.10.016. Epub 2011 Nov 17.
Although gender differences in pain and analgesia are well known, it still remains unclear whether men and women vary in response to multimodal pain treatment. This study was conducted to investigate whether men and women exhibited different outcomes after an intensive multimodal pain treatment program. The daily outpatient program consisted of individual treatment as well as group therapy, with a total amount of therapy of 117.5h per patient. Overall, 496 patients (254 women) completed the multimodal program. Pretreatment parameters for pain, disability due to pain, pain duration, and pain chronicity stage, as well as age or psychiatric comorbidities, did not differ between genders. The average pain, measured with a Numeric Rating Scale, decreased after treatment of -1.54 (±1.96) with a large effect size (ES) of .911 for the total sample. However, there were considerable differences in the benefit for women (-1.83±2.12; ES 1.045) compared with men (-1.23±1.74; ES .758). Consistently, women (ES .694) improved more in pain-related disabilities in daily life than men (ES .436). These distinctions are not due to differences in pain duration, received medication, psychiatric comorbidities, pain chronicity stage, or application for a disability pension. Therefore, gender differences not only refer to chronic pain prevalence, pain perception, or experimental pain measurement, but also seem to have a clinically relevant impact on the response to pain therapy.
尽管性别差异与疼痛和镇痛作用已经广为人知，但男性和女性在接受多模式疼痛治疗后的反应是否存在差异仍不明确。本研究旨在调查男性和女性在接受强化多模式疼痛治疗方案后是否存在不同的结局。该每日门诊方案包括个体治疗和团体治疗，每位患者的总治疗量为 117.5 小时。总体而言，496 名患者（254 名女性）完成了多模式方案。治疗前的疼痛、疼痛导致的残疾、疼痛持续时间和疼痛慢性阶段参数，以及年龄或合并精神疾病，在性别之间没有差异。疼痛的平均评分（用数字评分量表测量）在治疗后下降了-1.54（±1.96），总体样本的效应大小（ES）为.911。然而，女性（-1.83±2.12；ES 1.045）与男性（-1.23±1.74；ES.758）相比，获益程度存在显著差异。同样，女性（ES.694）在日常生活中与疼痛相关的残疾方面的改善程度大于男性（ES.436）。这些差异并非由于疼痛持续时间、接受的药物、合并精神疾病、疼痛慢性阶段或申请残疾抚恤金的不同所致。因此，性别差异不仅涉及慢性疼痛的患病率、疼痛感知或实验性疼痛测量，而且似乎对疼痛治疗的反应具有临床相关的影响。
