Cox Daniel R, Ashby Shaelene, DeConde Adam S, Mace Jess C, Orlandi Richard R, Smith Timothy L, Alt Jeremiah A
Sinus and Skull Base Surgery Program, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT.
Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, San Diego, CA.
Int Forum Allergy Rhinol. 2016 Mar;6(3):308-14. doi: 10.1002/alr.21664. Epub 2015 Nov 19.
Pain and depression often coexist as comorbidities in patients with chronic disease and exert a major impact on quality of life (QOL). Little is known about the relationship between pain and depression in chronic rhinosinusitis (CRS). Our objective was to investigate this relationship and to analyze the effect of pain and depression on QOL in CRS.
Patients with CRS were prospectively recruited as part of an observational cohort study. A total of 70 participants provided pain scores using both the Brief Pain Inventory Short Form (BPI-SF) and the Short Form McGill Pain Questionnaire (SF-MPQ). Patients at risk for depression were identified using the Patient Health Questionnaire-2 (PHQ-2). CRS-specific QOL was determined using the 22-item Sino-Nasal Outcome Test (SNOT-22).
Significant positive correlations were found between depression scores and all pain measures (R = 0.475 to 0.644, p < 0.001). Patients with a PHQ-2 score ≥1 had significantly higher scores on all reported pain measures. Significant positive correlations were found between all pain measures, the total SNOT-22 score, and 3 SNOT-22 subdomains (sleep, psychological dysfunction, and ear/facial symptoms; R = 0.323 to 0.608, p < 0.05).
Adult patients with CRS at risk for depression experience more pain and have overall worse disease-specific QOL. Further research investigating the complex interactions between depression and pain and the role it plays in CRS disease-specific QOL is warranted.
疼痛和抑郁在慢性病患者中常作为共病同时存在,并对生活质量(QOL)产生重大影响。关于慢性鼻-鼻窦炎(CRS)中疼痛与抑郁之间的关系,人们知之甚少。我们的目的是研究这种关系,并分析疼痛和抑郁对CRS患者生活质量的影响。
前瞻性招募CRS患者作为观察性队列研究的一部分。共有70名参与者使用简明疼痛问卷简表(BPI-SF)和麦吉尔疼痛问卷简表(SF-MPQ)提供疼痛评分。使用患者健康问卷2项版(PHQ-2)识别有抑郁风险的患者。使用22项鼻-鼻窦结局测试(SNOT-22)确定CRS特异性生活质量。
抑郁评分与所有疼痛指标之间均存在显著正相关(R = 0.475至0.644,p < 0.001)。PHQ-2评分≥1的患者在所有报告的疼痛指标上得分显著更高。所有疼痛指标、SNOT-22总分与3个SNOT-22子域(睡眠、心理功能障碍和耳/面部症状)之间均存在显著正相关(R = 0.323至0.608,p < 0.05)。
有抑郁风险的成年CRS患者经历更多疼痛,且其疾病特异性总体生活质量更差。有必要进一步研究抑郁与疼痛之间的复杂相互作用及其在CRS疾病特异性生活质量中所起的作用。