de Heer Eric W, Gerrits Marloes M J G, Beekman Aartjan T F, Dekker Jack, van Marwijk Harm W J, de Waal Margot W M, Spinhoven Philip, Penninx Brenda W J H, van der Feltz-Cornelis Christina M
TopClinical Center for Body, Mind, and Health, GGz Breburg Tilburg, Tilburg, The Netherlands; Tilburg School of Behavioral and Social Sciences, Tranzo Department, University of Tilburg, Tilburg, The Netherlands.
Department of Psychiatry, EMGO Institute for Health and Care research, VU University Medical Centre, Amsterdam, The Netherlands.
PLoS One. 2014 Oct 15;9(10):e106907. doi: 10.1371/journal.pone.0106907. eCollection 2014.
Chronic pain is commonly co-morbid with a depressive or anxiety disorder. Objective of this study is to examine the influence of depression, along with anxiety, on pain-related disability, pain intensity, and pain location in a large sample of adults with and without a depressive and/or anxiety disorder. The study population consisted of 2981 participants with a depressive, anxiety, co-morbid depressive and anxiety disorder, remitted disorder or no current disorder (controls). Severity of depressive and anxiety symptoms was also assessed. In separate multinomial regression analyses, the association of presence of depressive or anxiety disorders and symptom severity with the Chronic Pain Grade and location of pain was explored. Presence of a depressive (OR = 6.67; P<.001), anxiety (OR = 4.84; P<.001), or co-morbid depressive and anxiety disorder (OR = 30.26; P<.001) was associated with the Chronic Pain Grade. Moreover, symptom severity was associated with more disabling and severely limiting pain. Also, a remitted depressive or anxiety disorder showed more disabling and severely limiting pain (OR = 3.53; P<.001) as compared to controls. A current anxiety disorder (OR = 2.96; p<.001) and a co-morbid depressive and anxiety disorder (OR = 5.15; P<.001) were more strongly associated with cardio-respiratory pain, than gastro-intestinal or musculoskeletal pain. These findings remain after adjustment for chronic cardio respiratory illness. Patients with a current and remitted depressive and/or anxiety disorder and those with more severe symptoms have more disabling pain and pain of cardio-respiratory nature, than persons without a depressive or anxiety disorder. This warrants further research.
慢性疼痛通常与抑郁或焦虑障碍共病。本研究的目的是在一大群患有和未患有抑郁和/或焦虑障碍的成年人样本中，研究抑郁以及焦虑对疼痛相关残疾、疼痛强度和疼痛部位的影响。研究人群包括2981名参与者，他们患有抑郁、焦虑、共病抑郁和焦虑障碍、缓解期障碍或目前无疾病（对照组）。还评估了抑郁和焦虑症状的严重程度。在单独的多项回归分析中，探讨了抑郁或焦虑障碍的存在以及症状严重程度与慢性疼痛分级和疼痛部位的关联。患有抑郁（比值比[OR]=6.67；P<0.001）、焦虑（OR=4.84；P<0.001）或共病抑郁和焦虑障碍（OR=30.26；P<0.001）与慢性疼痛分级相关。此外，症状严重程度与更具致残性和严重限制性功能的疼痛相关。而且，与对照组相比，缓解期的抑郁或焦虑障碍也表现出更具致残性和严重限制性功能的疼痛（OR=3.53；P<0.001）。目前患有焦虑障碍（OR=2.96；P<0.001）和共病抑郁和焦虑障碍（OR=5.15；P<0.001）与心肺疼痛的关联比与胃肠道或肌肉骨骼疼痛的关联更强。在对慢性心肺疾病进行校正后，这些发现仍然成立。与没有抑郁或焦虑障碍的人相比，目前患有和处于缓解期的抑郁和/或焦虑障碍患者以及症状更严重的患者有更具致残性的疼痛和心肺性质的疼痛。这值得进一步研究。
