Lerman Sheera F, Rudich Zvia, Brill Silviu, Shalev Hadar, Shahar Golan
From the Department of Psychology (Lerman, Shahar), Ben-Gurion University of the Negev, Beer-Sheva, Israel; Pain Specialty Clinic (Rudich, Shalev), Soroka University Medical Center, Beer-Sheva, Israel; Chaim Sheba Medical Center (Lerman), Tel Hashomer, Israel; and Pain Specialty Clinic (Brill), Sourasky Medical Center, Tel-Aviv, Israel.
Psychosom Med. 2015 Apr;77(3):333-41. doi: 10.1097/PSY.0000000000000158.
The current study sets out to examine the longitudinal relationship between pain, pain-related disability, and symptoms of depression and anxiety. The latter symptoms are highly prevalent in chronic pain and seriously impede functioning and quality of life. Nevertheless, the direction of the relationship involving these variables among individuals with chronic pain is still unclear.
Four-hundred twenty-eight individuals with chronic pain (238 women, mean age 54.84 years, mean pain duration 85.21 months) treated at two pain clinics completed questionnaires regarding their pain (Short-Form McGill Pain Questionnaire), depression (Center for Epidemiological Studies-Depression Scale), state anxiety (State-Trait Anxiety Inventory), and pain-related disability (Pain Disability Index) at four time points, with an average of 5 months between measurements. Cross-lagged, structural equation modeling analyses were performed, enabling the examination of longitudinal associations between the variables.
Significant symptoms of both depression and anxiety were reported by more than half of the sample on all waves. A latent depression/anxiety variable longitudinally predicted pain (β = .27, p < .001) and pain-related disability (β = .38, p < .001). However, neither pain (β = .10, p = .126) nor pain-related disability (β = -.01, p = .790) predicted depression/anxiety.
Among adult patients with chronic pain treated at specialty pain clinics, high levels of depression and anxiety may worsen pain and pain-related disability.
本研究旨在探讨疼痛、疼痛相关残疾与抑郁和焦虑症状之间的纵向关系。后两种症状在慢性疼痛中非常普遍，严重妨碍功能和生活质量。然而，慢性疼痛患者中这些变量之间关系的方向仍不明确。
在两家疼痛诊所接受治疗的428名慢性疼痛患者（238名女性，平均年龄54.84岁，平均疼痛持续时间85.21个月）在四个时间点完成了关于疼痛（简短麦吉尔疼痛问卷）、抑郁（流行病学研究中心抑郁量表）、状态焦虑（状态-特质焦虑量表）和疼痛相关残疾（疼痛残疾指数）的问卷调查，测量之间平均间隔5个月。进行了交叉滞后结构方程模型分析，以检验变量之间的纵向关联。
在所有测量波次中，超过一半的样本报告了显著的抑郁和焦虑症状。一个潜在的抑郁/焦虑变量纵向预测疼痛（β = 0.27，p < 0.001）和疼痛相关残疾（β = 0.38，p < 0.001）。然而，疼痛（β = 0.10，p = 0.126）和疼痛相关残疾（β = -0.01，p = 0.790）均未预测抑郁/焦虑。
在专科疼痛诊所接受治疗的成年慢性疼痛患者中，高水平的抑郁和焦虑可能会加重疼痛和疼痛相关残疾。
