Yamada Keiko, Matsudaira Ko, Tanaka Eizaburo, Oka Hiroyuki, Katsuhira Junji, Iso Hiroyasu
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka; Center for Pain Management, Osaka University Hospital, Suita, Osaka.
Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo; Japan Labour Health & Welfare Organization, Tokyo.
J Pain Res. 2017 Feb 16;10:427-433. doi: 10.2147/JPR.S125556. eCollection 2017.
Responses to early-life adversity may differ by sex. We investigated the sex-specific impact of early-life adversity on chronic pain, chronic multisite pain, and somatizing tendency with chronic pain.
We examined 4229 respondents aged 20-79 years who participated in the Pain Associated Cross-Sectional Epidemiological Survey in Japan. Outcomes were: 1) chronic pain prevalence, 2) multisite pain (≥3 sites) prevalence, and 3) multiple somatic symptoms (≥3 symptoms) among respondents with chronic pain related to the presence or absence of early-life adversity. Multivariable-adjusted odds ratios (ORs) were calculated with 95% confidence intervals using a logistic regression model including age, smoking status, exercise routine, sleep time, body mass index, household expenditure, and the full distribution of scores on the Mental Health Inventory-5. We further adjusted for pain intensity when we analyzed the data for respondents with chronic pain.
The prevalence of chronic pain was higher among respondents reporting the presence of early-life adversity compared with those reporting its absence, with multivariable ORs of 1.62 (1.22-2.15, <0.01) in men and 1.47 (1.13-1.90, <0.01) in women. Among women with chronic pain, early-life adversity was associated with multisite pain and multiple somatic symptoms; multivariable ORs were 1.78 (1.22-2.60, <0.01) for multisite pain and 1.89 (1.27-2.83, <0.01) for ≥3 somatic symptoms. No associations were observed between early-life adversity and chronic multisite pain or multiple somatic symptoms among men with chronic pain.
Early-life adversity may be linked to a higher prevalence of chronic pain among both sexes and to multisite pain and somatizing tendency among women with chronic pain.
对早年逆境的反应可能因性别而异。我们研究了早年逆境对慢性疼痛、慢性多部位疼痛以及伴有慢性疼痛的躯体化倾向的性别特异性影响。
我们调查了4229名年龄在20 - 79岁之间、参与日本疼痛相关横断面流行病学调查的受访者。结果包括：1）慢性疼痛患病率；2）多部位疼痛（≥3个部位）患病率；3）在患有与早年逆境存在与否相关的慢性疼痛的受访者中，多种躯体症状（≥3种症状）的情况。使用包含年龄、吸烟状况、运动习惯、睡眠时间、体重指数、家庭支出以及心理健康量表-5得分的全部分布情况的逻辑回归模型，计算多变量调整后的比值比（OR）及其95%置信区间。在分析慢性疼痛受访者的数据时，我们还对疼痛强度进行了进一步调整。
报告有早年逆境的受访者中慢性疼痛的患病率高于报告无早年逆境的受访者，男性的多变量OR为1.62（1.22 - 2.15，<0.01），女性为1.47（1.13 - 1.90，<0.01）。在患有慢性疼痛的女性中，早年逆境与多部位疼痛和多种躯体症状相关；多部位疼痛的多变量OR为1.78（1.22 - 2.60，<0.01），≥3种躯体症状的多变量OR为1.89（1.27 - 2.83，<0.01）。在患有慢性疼痛的男性中，未观察到早年逆境与慢性多部位疼痛或多种躯体症状之间存在关联。
早年逆境可能与两性中慢性疼痛的较高患病率以及患有慢性疼痛的女性中的多部位疼痛和躯体化倾向有关。
