Department of Public Health, Hedmark University College, Elverum, Norway ; Innlandet Hospital Trust, PO Box 104, N-2381 Brumunddal, Norway.
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway ; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
BMC Psychol. 2015 Mar 15;3(1):7. doi: 10.1186/s40359-015-0064-5. eCollection 2015.
Traumatized refugees often report significant levels of chronic pain in addition to posttraumatic stress disorder symptoms, and more information is needed to understand pain in refugees exposed to traumatic events. This study aimed to assess the frequency of chronic pain among refugee psychiatric outpatients, and to compare outpatients with and without chronic pain on trauma exposure, psychiatric morbidity, and psychiatric symptom severity.
We conducted a cross-sectional study of sixty-one psychiatric outpatients with a refugee background using structured clinical diagnostic interviews to assess for traumatic events [Life Events Checklist (LEC)], PTSD (Posttraumatic Stress Disorder) and complex PTSD [Structured Clinical Interview for DSM-IV PTSD Module (SCID-PTSD) and Structured Interview for Disorders of Extreme Stress (SIDES)], chronic pain (SIDES Scale VI) and psychiatric symptoms [M.I.N.I. International Neuropsychiatric Interview (M.I.N.I.)]. Self-report measures were used to assess symptoms of posttraumatic stress [Impact of Event Scale-revised (IES-R)], depression and anxiety [Hopkins Symptom Checklist (HSCL-25)] and several markers of acculturation in Norway.
Of the 61 outpatients included, all but one reported at least one chronic pain location, with a mean of 4.6 locations per patient. Chronic pain at clinical levels was present in 66% of the whole sample of outpatients, and in 88% of the outpatients with current PTSD diagnosis. The most prevalent chronic pain locations were head (80%), chest (74%), arms/legs (66%) and back (62%). Women had significantly more chronic pain locations than men. Comorbid PTSD and chronic pain were found in 57% of the outpatients. Significant differences were found between outpatients with and without chronic pain on posttraumatic stress, psychological distress, and DESNOS severity.
Chronic pains are common in multi-traumatized refugees in outpatient clinics in Norway, and are positively related to symptomatology and severity of psychiatric morbidity. The presence of chronic pain, as well as comorbid chronic pain and PTSD, in psychiatric outpatients with a refugee background call for an integrated assessment and treatment for both conditions.
创伤后难民除了患有创伤后应激障碍（PTSD）外，还经常报告存在严重的慢性疼痛，为了更好地了解经历创伤事件的难民的疼痛情况，需要获取更多信息。本研究旨在评估有难民背景的精神科门诊患者中慢性疼痛的发生率，并比较有和无慢性疼痛的患者在创伤暴露、精神疾病发病率和精神症状严重程度方面的差异。
我们对 61 名有难民背景的精神科门诊患者进行了横断面研究，使用结构化临床诊断访谈来评估创伤事件（生活事件检查表[LEC]）、创伤后应激障碍（PTSD）和复杂 PTSD（DSM-IV PTSD 模块的结构临床访谈[SCID-PTSD]和极端应激障碍的结构访谈[SIDES]）、慢性疼痛（SIDES 量表 VI）和精神症状（MINI 国际神经精神访谈[MINI]）。使用自我报告量表评估创伤后应激症状（修订后的事件影响量表[IES-R]）、抑郁和焦虑症状（霍普金斯症状清单[HSCL-25]）以及在挪威的几种文化适应标志物。
在纳入的 61 名门诊患者中，除 1 名患者外，所有人均报告了至少 1 个慢性疼痛部位，平均每位患者有 4.6 个疼痛部位。整个门诊患者样本中，有 66%的患者存在慢性疼痛，且当前 PTSD 诊断的门诊患者中，有 88%的患者存在慢性疼痛。最常见的慢性疼痛部位是头部（80%）、胸部（74%）、手臂/腿部（66%）和背部（62%）。女性的慢性疼痛部位比男性多。在门诊患者中，有 PTSD 和慢性疼痛共病的患者占 57%。有和无慢性疼痛的门诊患者在创伤后应激、心理困扰和 DESNOS 严重程度方面存在显著差异。
在挪威的精神科门诊中，患有多种创伤的难民中慢性疼痛很常见，且与精神疾病发病率和严重程度呈正相关。有慢性疼痛、慢性疼痛和 PTSD 共病的精神科门诊患者中存在慢性疼痛，这呼吁对这两种疾病进行综合评估和治疗。
