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马凡综合征中疼痛、功能障碍及心理负担的特征分析

Characterization of pain, disability, and psychological burden in Marfan syndrome.

作者信息

Speed Traci J, Mathur Vani A, Hand Matthew, Christensen Bryt, Sponseller Paul D, Williams Kayode A, Campbell Claudia M

机构信息

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Department of Psychology, Texas A&M University, College Station, Texas.

出版信息

Am J Med Genet A. 2017 Feb;173(2):315-323. doi: 10.1002/ajmg.a.38051. Epub 2016 Nov 14.

Abstract

The clinical manifestations of Marfan syndrome frequently cause pain. This study aimed to characterize pain in a cohort of adults with Marfan syndrome and investigate demographic, physical, and psychological factors associated with pain and pain-related disability. Two hundred and forty-five participants (73% female, 89% non-Hispanic white, 90% North American) completed an online questionnaire assessing clinical features of Marfan syndrome, pain severity, pain-related disability, physical and mental health, depressive symptoms, pain catastrophizing, and insomnia. Eighty-nine percent of respondents reported having pain with 28% of individuals reporting pain as a presenting symptom of Marfan syndrome. Almost half of individuals reported that pain has spread from its initial site. Participants in our study reported poor physical and mental health functioning, moderate pain-related disability, and mild levels of depressive symptoms, sleep disturbances, and pain catastrophizing. Those who identified pain as an initial symptom of Marfan syndrome and those who reported that pain had spread from its initial site reported greater psychological burden compared with those without pain as an initial symptom or pain spreading. Physical health is the largest predictor of pain severity and pain-related disability. While pain catastrophizing and worse mental health functioning are significant correlates of pain severity and pain-related disability, respectively. Pain is a significant and persistent problem in Marfan syndrome and is associated with profound disability and psychological burden. Further studies are indicated to better characterize the directionality of pain, pain-related disability, and psychological burden in Marfan syndrome. © 2016 Wiley Periodicals, Inc.

摘要

马凡综合征的临床表现常引发疼痛。本研究旨在描述一组成年马凡综合征患者的疼痛特征,并调查与疼痛及疼痛相关残疾相关的人口统计学、身体和心理因素。245名参与者(73%为女性,89%为非西班牙裔白人,90%来自北美)完成了一份在线问卷,评估马凡综合征的临床特征、疼痛严重程度、疼痛相关残疾、身心健康、抑郁症状、疼痛灾难化和失眠情况。89%的受访者报告有疼痛,其中28%的人将疼痛作为马凡综合征的首发症状。近一半的人报告疼痛已从最初部位扩散。我们研究中的参与者报告身心健康状况不佳、疼痛相关残疾程度中等,抑郁症状、睡眠障碍和疼痛灾难化程度较轻。与无疼痛首发症状或疼痛未扩散的人相比,那些将疼痛视为马凡综合征首发症状的人和报告疼痛已从最初部位扩散的人报告的心理负担更大。身体健康是疼痛严重程度和疼痛相关残疾的最大预测因素。而疼痛灾难化和较差的心理健康状况分别是疼痛严重程度和疼痛相关残疾的显著相关因素。疼痛是马凡综合征中一个显著且持续存在的问题,与严重残疾和心理负担相关。需要进一步研究以更好地描述马凡综合征中疼痛的方向性、疼痛相关残疾和心理负担。© 2016威利期刊公司

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