Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98133, USA.
Rehabil Psychol. 2013 May;58(2):217-21. doi: 10.1037/a0032008.
PURPOSE/OBJECTIVE: To define the rates of pain, depression, and their co-occurrence in persons with multiple sclerosis (MS).
RESEARCH METHOD/DESIGN: Participants were 161 persons with MS who previously participated in research and indicated a willingness to be contacted for future studies. Data were collected via postal survey and included the Patient Health Questionnaire-9 for depressive symptoms and a numerical rating scale (0-10) for pain. Descriptive statistics, chi-square analyses, and odds ratios were calculated to describe the prevalence, difference, and likelihood of depression, pain, and their comorbidity.
Some level of pain was experienced by 73% of the sample, with 40% of the entire sample reporting moderate or worse pain severity. Clinically significant levels of depressive symptoms were reported by 22% of the sample, and 8% reported sufficient symptoms to meet major depressive episode diagnostic criteria. Of persons meeting depression criteria, 86-100% reported experiencing any pain; 67-77% of persons meeting depression criteria reported experiencing pain of at least moderate severity. Of persons experiencing any pain, 11-34% met depression criteria; 15-37% of persons experiencing pain of at least moderate severity met depression criteria.
CONCLUSIONS/IMPLICATIONS: Pain and depression co-occur frequently in persons with MS. However, it is more common for individuals with depression to report pain than for individuals with pain to endorse symptoms of depression. Future studies should explore the implications of this co-occurrence, such as whether these individuals experience greater levels of disability, higher medical costs, or fewer benefits from treatment than persons with either condition alone.
目的/目标：定义多发性硬化症（MS）患者的疼痛、抑郁及其共病的发生率。
研究方法/设计：参与者为 161 名曾参与研究并表示愿意接受未来研究联系的 MS 患者。数据通过邮寄调查收集，包括用于抑郁症状的患者健康问卷-9 和用于疼痛的数字评分量表（0-10）。计算描述性统计、卡方分析和优势比，以描述患病率、差异和抑郁、疼痛及其共病的发生可能性。
该样本中有 73%的人经历了某种程度的疼痛，整个样本中有 40%的人报告疼痛严重程度为中度或更严重。22%的样本报告了临床显著水平的抑郁症状，8%的样本报告了足够的症状符合重性抑郁发作的诊断标准。在符合抑郁标准的人中，86-100%报告有任何疼痛；在符合抑郁标准的人中，67-77%报告有至少中度严重程度的疼痛。在经历任何疼痛的人中，11-34%符合抑郁标准；在经历至少中度严重程度疼痛的人中，15-37%符合抑郁标准。
结论/意义：多发性硬化症患者中疼痛和抑郁常常共病。然而，报告疼痛的抑郁患者比报告疼痛的患者更常见。未来的研究应该探讨这种共病的影响，例如这些患者是否比单独患有任何一种疾病的患者经历更高的残疾水平、更高的医疗费用或治疗获益更少。
