Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan.
J Pain. 2013 Nov;14(11):1390-7. doi: 10.1016/j.jpain.2013.06.010. Epub 2013 Sep 7.
Although chronic pain in childhood can last into adulthood, few studies have evaluated the characteristics of adults with chronic pain who report childhood chronic pain. Thus, 1,045 new patients (mean age, 49.5 ± 15.4) at an academic tertiary care pain clinic were prospectively evaluated using validated self-report questionnaires. Patients also responded to questions about childhood pain. We found that almost 17% (n = 176) of adult chronic pain patients reported a history of chronic pain in childhood or adolescence, with close to 80% indicating that the pain in childhood continues today. Adults reporting childhood chronic pain were predominantly female (68%), commonly reported widespread pain (85%), and had almost 3 times the odds of meeting survey criteria for fibromyalgia (odds ratio [OR] = 2.94, 95% confidence interval [CI] = 2.04-4.23) than those denying childhood chronic pain. Similarly, those with childhood pain had twice the odds of having biological relatives with chronic pain (OR = 2.03, 95% CI = 1.39-2.96) and almost 3 times the odds of having relatives with psychiatric illness (OR = 2.85, 95% CI = 1.97-4.11). Lastly, compared to patients who did not report childhood chronic pain, those who did were more likely to use neuropathic descriptors for their pain (OR = 1.82, 95% CI = 1.26-2.64), have slightly worse functional status (B = -2.12, t = -3.10, P = .002), and have increased anxiety (OR = 1.77, 95% CI = 1.24-2.52).
Our study revealed that 1 in 6 adult pain patients reported pain that dated back to childhood or adolescence. In such patients, evidence suggested that their pain was more likely to be widespread, neuropathic in nature, and accompanied by psychological comorbidities and decreased functional status.
尽管儿童时期的慢性疼痛可能会持续到成年期，但很少有研究评估报告儿童期慢性疼痛的成年慢性疼痛患者的特征。因此，我们前瞻性地使用经过验证的自我报告问卷评估了 1045 名新患者（平均年龄，49.5 ± 15.4）在学术性三级护理疼痛诊所。患者还回答了有关儿童期疼痛的问题。我们发现，近 17%（n = 176）的成年慢性疼痛患者报告称他们在儿童或青少年时期有慢性疼痛史，近 80%的患者表示儿童期的疼痛至今仍在持续。报告儿童期慢性疼痛的成年人主要为女性（68%），常报告广泛疼痛（85%），并且符合纤维肌痛调查标准的可能性是否认儿童期慢性疼痛的患者的近 3 倍（优势比 [OR] = 2.94，95%置信区间 [CI] = 2.04-4.23）。同样，有儿童期疼痛的人有生物亲属患有慢性疼痛的几率是没有儿童期疼痛的人的两倍（OR = 2.03，95% CI = 1.39-2.96），有精神疾病亲属的几率几乎是没有儿童期疼痛的人的三倍（OR = 2.85，95% CI = 1.97-4.11）。最后，与未报告儿童期慢性疼痛的患者相比，报告有儿童期慢性疼痛的患者更有可能使用神经病理性描述词来描述他们的疼痛（OR = 1.82，95% CI = 1.26-2.64），功能状态稍差（B = -2.12，t = -3.10，P =.002），焦虑增加（OR = 1.77，95% CI = 1.24-2.52）。
我们的研究表明，每 6 名成年疼痛患者中就有 1 名报告称疼痛可追溯至儿童或青少年时期。在这些患者中，有证据表明他们的疼痛更有可能是广泛的、神经病理性的，并伴有心理合并症和功能状态下降。
