Health Outcomes Practice, Kantar Health, Milan, Italy.
Tokyo Shinjuku Medical Center, Tokyo, Japan.
Neuropsychiatr Dis Treat. 2015 Mar 13;11:675-83. doi: 10.2147/NDT.S71768. eCollection 2015.
Depression is often associated with painful physical symptoms. Previous research has seldom assessed the relationship between the severity of physical symptoms and the severity of mental and emotional symptoms of depression or other health outcomes, and no such studies have been conducted previously among individuals with depression in Japan. The aim of this study was to assess the relationship between the severity of physical pain and depression and other outcomes among individuals in Japan diagnosed with depression.
Data for individuals aged 18 and older in Japan who reported being diagnosed with depression and also reported physical pain were obtained from the Japan National Health and Wellness Survey. These respondents were characterized on sociodemographics and health characteristics, and the relationship between ratings of severity on pain in the last week and health outcomes were assessed using bivariate correlations and generalized linear models. Measures included the Patient Health Questionnaire for depression severity, Medical Outcomes Study 12-Item Short Form Survey Instrument for health-related quality of life, the Work Productivity and Activity Impairment for work and activity impairment, and 6-month report of health care use.
More severe physical pain in the past week was correlated with more severe depression, worse health-related quality of life, lower health utility, greater impairment at work, and more health care provider visits. These relationships remained significant after incorporating sociodemographics and health characteristics in the statistical models.
Individuals whose depression is accompanied by more severe physical pain have a higher burden of illness than those whose depression includes less severe pain, suggesting that even partially ameliorating painful physical symptoms may significantly benefit patients with depression. Clinicians should take the presence and severity of physical pain into account and consider treating both the physical and emotional symptoms of these patients.
抑郁症常伴有躯体疼痛症状。既往研究较少评估躯体症状严重程度与抑郁的精神和情绪症状严重程度或其他健康结局之间的关系，且既往在日本尚未开展针对抑郁患者的此类研究。本研究旨在评估日本抑郁患者的躯体疼痛严重程度与抑郁及其他结局之间的关系。
本研究数据来源于日本全国健康与健康调查，纳入报告患有抑郁且报告有躯体疼痛的年龄≥18 岁的个体。这些受访者的社会人口学和健康特征均进行了特征描述，并使用双变量相关性和广义线性模型评估过去一周疼痛严重程度评分与健康结局之间的关系。评估指标包括抑郁严重程度患者健康问卷、健康相关生活质量医疗结局研究 12 项简明量表、工作和活动障碍工作生产力和活动障碍量表、以及 6 个月的医疗保健使用报告。
过去一周更严重的躯体疼痛与更严重的抑郁、更差的健康相关生活质量、更低的健康效用、更严重的工作障碍以及更多的医疗保健提供者就诊相关。将社会人口学和健康特征纳入统计模型后，这些关系仍然具有统计学意义。
与疼痛程度较轻的抑郁患者相比，伴更严重躯体疼痛的抑郁患者的疾病负担更重，这提示即使部分缓解躯体疼痛症状也可能使抑郁患者显著获益。临床医生应考虑到躯体疼痛的存在和严重程度，并考虑治疗这些患者的躯体和情绪症状。
