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慢性盆腔疼痛综合征(CPPS)患者的精神障碍

Mental disorders in patients with chronic pelvic pain syndrome (CPPS).

作者信息

Brünahl Christian, Dybowski Christoph, Albrecht Rebecca, Riegel Björn, Höink Johanna, Fisch Margit, Löwe Bernd

机构信息

Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany.

Department of Gynecology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

出版信息

J Psychosom Res. 2017 Jul;98:19-26. doi: 10.1016/j.jpsychores.2017.04.011. Epub 2017 Apr 22.

Abstract

OBJECTIVE

Chronic pelvic pain syndrome (CPPS) is a debilitating pain condition with prevalence rates between 2.0% and 26.6%. Studies indicate that CPPS is often associated with psychosocial factors, but little is known about the presence of full-blown mental disorders in female and male patients with CPPS. Therefore, the aim of this study was to investigate the frequencies of mental disorders in patients with CPPS.

METHODS

Cross-sectional data were collected from patients visiting a specialized outpatient clinic. Frequencies of mental disorders were investigated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and compared to the general population. Furthermore, self-rating questionnaires were used to assess somatic symptom severity (PHQ-15), depression severity (PHQ-9) and anxiety severity (GAD-7).

RESULTS

Data from 178 CPPS patients (60.1% female; age M=49.1, SD=18.0) were analyzed. Of the total sample, 95.2% (95% CI 90.8-97.9) suffered from at least one mental disorder. The most prevalent mental disorders were somatoform disorders (91.7%; 95% CI 86.4-95.4), followed by mood disorders (50.6%; 95% CI 42.8-58.4) and anxiety disorders (32.1%; 95% CI 25.2-39.8). The self-reported symptom burden was also significantly higher than in the general population. Compared to men, women met the diagnoses of somatoform (p=0.012) and anxiety disorders (p=0.027) significantly more often and reported a significantly higher total somatic symptom severity (p=0.001).

CONCLUSION

Our results provide evidence for a clinically relevant psychosocial symptom burden in patients with CPPS, indicating the need for the examination of psychopathologies and multi-professional treatment for this patient group.

摘要

目的

慢性盆腔疼痛综合征(CPPS)是一种使人衰弱的疼痛病症,患病率在2.0%至26.6%之间。研究表明,CPPS常与心理社会因素相关,但对于患有CPPS的女性和男性患者中是否存在全面的精神障碍知之甚少。因此,本研究的目的是调查CPPS患者中精神障碍的发生率。

方法

收集来自一家专门门诊的患者的横断面数据。使用《精神疾病诊断与统计手册》第四版轴I障碍的结构化临床访谈(SCID-I)调查精神障碍的发生率,并与普通人群进行比较。此外,使用自评问卷评估躯体症状严重程度(PHQ-15)、抑郁严重程度(PHQ-9)和焦虑严重程度(GAD-7)。

结果

分析了178例CPPS患者的数据(60.1%为女性;年龄M = 49.1,SD = 18.0)。在总样本中,95.2%(95%置信区间90.8 - 97.9)患有至少一种精神障碍。最常见的精神障碍是躯体形式障碍(91.7%;95%置信区间86.4 - 95.4),其次是情绪障碍(50.6%;95%置信区间42.8 - 58.4)和焦虑障碍(32.1%;95%置信区间25.2 - 39.8)。自我报告的症状负担也显著高于普通人群。与男性相比,女性更常被诊断为躯体形式障碍(p = 0.012)和焦虑障碍(p = 0.027),并且报告的总体躯体症状严重程度显著更高(p = 0.001)。

结论

我们的结果为CPPS患者存在临床上相关的心理社会症状负担提供了证据,表明需要对该患者群体进行精神病理学检查和多专业治疗。

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