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精神科患者的疼痛主观体验与精神病理学之间有何关系?

How does subjective experience of pain relate to psychopathology among psychiatric patients?

机构信息

Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.

出版信息

Gen Hosp Psychiatry. 2012 Sep-Oct;34(5):534-40. doi: 10.1016/j.genhosppsych.2012.03.022. Epub 2012 May 15.

Abstract

OBJECTIVE

The study aimed to investigate to what extent general psychopathology is associated with subjective experience of pain in psychiatric outpatients without comorbidity with severe physical diagnosis and whether there are any differences in the experience of pain between genders or diagnoses.

METHOD

Participants were 575 consecutive outpatients affected by mood disorder or anxiety disorder. Patients completed the West Haven-Yale Multidimensional Pain Inventory (WHYMPI) and the Symptom Checklist 90-Revised.

RESULTS

Women had higher mean scores on the Global Severity Index (1.52±0.76 vs. 1.33±0.79), higher perception of negative responses from others (1.84±1.59 vs. 1.46±1.35) and higher perception of pain severity (3.31±1.73 vs. 2.88±1.63) than men. They also reported higher mean scores on the WHYMPI's General Activity (2.14±0.98 vs. 1.93±0.95) and Household Chores (3.64±1.75 vs. 2.27±1.58) and lower mean scores on the Outdoor Work (1.24±1.26 vs. 1.87±1.51) dimension than men. Higher pain severity, more negative responses from others and higher household chores are predictors of higher psychopathology, while the general level of activity may be considered as a protective factor.

CONCLUSIONS

Pain and its subjective experience play a central role in psychiatric disorders, and it is a great burden for patients and caregivers. Clinicians should pay more attention to recognize and adequately treat painful symptoms in patients with anxiety and depressive disorder.

摘要

目的

本研究旨在探讨在没有严重躯体诊断共病的情况下,一般精神病理学与精神科门诊患者主观疼痛体验的关联程度,以及性别或诊断之间在疼痛体验方面是否存在差异。

方法

参与者为 575 名连续就诊的心境障碍或焦虑障碍患者。患者完成了 West Haven-Yale 多维疼痛量表(WHYMPI)和症状清单 90 修订版(SCL-90-R)。

结果

女性在总体严重度指数(1.52±0.76 与 1.33±0.79)、对他人负面反应的感知(1.84±1.59 与 1.46±1.35)和对疼痛严重程度的感知(3.31±1.73 与 2.88±1.63)方面的平均得分均高于男性。她们在 WHYMPI 的一般活动(2.14±0.98 与 1.93±0.95)和家务活动(3.64±1.75 与 2.27±1.58)维度的平均得分较高,而在户外工作(1.24±1.26 与 1.87±1.51)维度的平均得分较低。较高的疼痛严重度、更多的他人负面反应和更多的家务活动是精神病理学较高的预测因素,而一般活动水平则可能是一个保护因素。

结论

疼痛及其主观体验在精神障碍中起着核心作用,对患者和照护者来说是一个巨大的负担。临床医生应更加关注识别和充分治疗焦虑和抑郁障碍患者的疼痛症状。

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