MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK Department of Epidemiology and Public Health, University College London, London, UK.
Pain. 2012 Dec;153(12):2339-2344. doi: 10.1016/j.pain.2012.07.027.
Psychological factors are thought to play a part in the aetiology of chronic widespread pain. We investigated the relationship between intelligence in childhood and risk of chronic widespread pain in adulthood in 6902 men and women from the National Child Development Survey (1958 British Birth Cohort). Participants took a test of general cognitive ability at age 11 years; and chronic widespread pain, defined according to the American College of Rheumatology criteria, was assessed at age 45 years. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using log-binomial regression, adjusting for sex and potential confounding or mediating factors. Risk of chronic widespread pain, defined according to the American College of Rheumatology criteria, rose in a stepwise fashion as intelligence fell (P for linear trend <0.0001). In sex-adjusted analyses, for an SD lower intelligence quotient, the RR of chronic widespread pain was 1.26 (95% CI 1.17-1.35). In multivariate backwards stepwise regression, lower childhood intelligence remained as an independent predictor of chronic widespread pain (RR 1.10; 95% CI 1.01-1.19), along with social class, educational attainment, body mass index, smoking status, and psychological distress. Part of the effect of lower childhood intelligence on risk of chronic widespread pain in midlife was significantly mediated through greater body mass index and more disadvantaged socioeconomic position. Men and women with higher intelligence in childhood are less likely as adults to report chronic widespread pain.
心理因素被认为在慢性广泛性疼痛的病因学中起作用。我们研究了童年智力与成年期慢性广泛性疼痛风险之间的关系，研究对象是来自全国儿童发展调查（1958 年英国出生队列）的 6902 名男性和女性。参与者在 11 岁时接受了一般认知能力测试；在 45 岁时，根据美国风湿病学会的标准评估慢性广泛性疼痛。使用对数二项式回归估计风险比（RR）和 95%置信区间（CI），调整性别和潜在的混杂或中介因素。根据美国风湿病学会的标准，慢性广泛性疼痛的风险呈阶梯式上升，随着智力下降而上升（P<0.0001 线性趋势）。在性别调整分析中，对于智商降低一个标准差，慢性广泛性疼痛的 RR 为 1.26（95%CI 1.17-1.35）。在多变量向后逐步回归中，较低的儿童智力仍然是慢性广泛性疼痛的独立预测因素（RR 1.10；95%CI 1.01-1.19），同时还有社会阶层、教育程度、体重指数、吸烟状况和心理困扰。较低的儿童智力对中年慢性广泛性疼痛风险的部分影响，通过更大的体重指数和更不利的社会经济地位得到显著介导。童年智力较高的男性和女性成年后更不容易报告慢性广泛性疼痛。
