GGz Breburg, Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, the Netherlands.
Tranzo Department, Tilburg School of Behavioural and Social Sciences, Tilburg University, Tilburg, the Netherlands.
Pain. 2018 Apr;159(4):712-718. doi: 10.1097/j.pain.0000000000001133.
Pain might be an important risk factor for common mental disorders. Insight into the longitudinal association between pain and common mental disorders in the general adult population could help improve prevention and treatment strategies. Data were used from the first 2 waves of the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among the Dutch general population aged 18 to 64 years at baseline (N = 5303). Persons without a mental disorder 12 months before baseline were selected as the at-risk group (n = 4974 for any mood disorder; n = 4979 for any anxiety disorder; and n = 5073 for any substance use disorder). Pain severity and interference due to pain in the past month were measured at baseline using the Short Form Health Survey. DSM-IV mental disorders were assessed at both waves using the Composite International Diagnostic Interview version 3.0. Moderate to very severe pain was associated with a higher risk of mood (odds ratio [OR] = 2.10, 95% confidence interval [CI] = 1.33-3.29) or anxiety disorders (OR = 2.12, 95% CI = 1.27-3.55). Moderate to very severe interference due to pain was also associated with a higher risk of mood (OR = 2.14, 95% CI = 1.30-3.54) or anxiety disorders (OR = 1.92, 95% CI = 1.05-3.52). Pain was not significantly associated with substance use disorders. No interaction effects were found between pain severity or interference due to pain and a previous history of mental disorders. Moderate to severe pain and interference due to pain are strong risk factors for first-incident or recurrent mood and anxiety disorders, independent of other mental disorders. Pain management programs could therefore possibly also serve as a preventative program for mental disorders.
疼痛可能是常见精神障碍的一个重要危险因素。了解一般成年人群中疼痛与常见精神障碍之间的纵向关联,可以帮助改善预防和治疗策略。本研究的数据来自荷兰精神健康调查和发病率研究-2 的前 2 个波次,这是一项在基线时年龄为 18 至 64 岁的荷兰一般人群中进行的精神流行病学队列研究。选择没有精神障碍且在基线前 12 个月的人作为风险组(任何心境障碍的人数为 4974 人;任何焦虑障碍的人数为 4979 人;任何物质使用障碍的人数为 5073 人)。使用简短健康调查在基线时测量过去 1 个月的疼痛严重程度和疼痛干扰情况。使用复合国际诊断访谈第 3.0 版在两个波次评估 DSM-IV 精神障碍。中度至非常严重的疼痛与心境障碍(优势比 [OR] = 2.10,95%置信区间 [CI] = 1.33-3.29)或焦虑障碍(OR = 2.12,95% CI = 1.27-3.55)的风险增加相关。中度至非常严重的疼痛干扰也与心境障碍(OR = 2.14,95% CI = 1.30-3.54)或焦虑障碍(OR = 1.92,95% CI = 1.05-3.52)的风险增加相关。疼痛与物质使用障碍无显著相关性。未发现疼痛严重程度或疼痛干扰与先前精神障碍史之间存在交互作用。中度至严重的疼痛和疼痛干扰是首次发生或复发心境和焦虑障碍的强烈危险因素,与其他精神障碍无关。因此,疼痛管理计划可能也可以作为预防精神障碍的一个项目。