Anxiety and Illness Behaviour Laboratory, Department of Psychology, University of Regina, Regina, SK, S4S 0A2, Canada.
Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0W3, Canada.
J Anxiety Disord. 2018 Apr;55:48-55. doi: 10.1016/j.janxdis.2018.03.006. Epub 2018 Mar 13.
Canadian Public Safety Personnel (PSP; e.g., correctional service officers, dispatchers, firefighters, paramedics, police officers) regularly experience potentially traumatic, painful, and injurious events. Such exposures increase risk for developing mental disorders and chronic pain, which both involve substantial personal and social costs. The interrelationship between mental disorders and chronic pain is well-established, and both can be mutually maintaining; accordingly, understanding the relationship between mental health and chronic pain among PSP is important for improving health care. Unfortunately, the available research on such comorbidity for PSP is sparse. The current study was designed to provide initial estimates of comorbidities between mental disorders and chronic pain across diverse PSP. Participants included 5093 PSP (32% women) in six categories (i.e., Call Center Operators/Dispatchers, Correctional Workers, Firefighters, Municipal/Provincial Police, Paramedics, Royal Canadian Mounted Police) who participated in a large PSP mental health survey. The survey included established self-report measures for mental disorders and chronic pain. In the total sample, 23.1% of respondents self-reported clinically significant comorbid concerns with both mental disorders and chronic pain. The results indicated PSP who reported chronic pain were significantly more likely to screen positive for posttraumatic stress disorder (PTSD), major depressive disorder, generalized anxiety disorder, social anxiety disorder, and alcohol use disorder. There were differences between PSP categories; but, the most consistent indications of comorbidity were for chronic pain, PTSD, and major depressive disorder. Comorbidity between chronic pain and mental disorders among PSP is prevalent. Health care providers should regularly assess PSP for both symptom domains.
加拿大公共安全人员(PSP;例如惩教服务人员、调度员、消防员、护理人员、警察)经常经历潜在的创伤性、痛苦和伤害性事件。这种暴露会增加患精神障碍和慢性疼痛的风险,而这两种疾病都涉及到巨大的个人和社会成本。精神障碍和慢性疼痛之间的相互关系是明确的,两者都可以相互维持;因此,了解 PSP 中的心理健康和慢性疼痛之间的关系对于改善医疗保健很重要。不幸的是,关于 PSP 这种共病的可用研究很少。本研究旨在为不同 PSP 之间的精神障碍和慢性疼痛共病提供初步估计。参与者包括来自六个类别的 5093 名 PSP(32%为女性)(即呼叫中心运营商/调度员、惩教人员、消防员、市/省警察、护理人员、加拿大皇家骑警),他们参加了一项大型 PSP 心理健康调查。该调查包括用于精神障碍和慢性疼痛的既定自我报告措施。在总样本中,23.1%的受访者自我报告存在同时患有精神障碍和慢性疼痛的临床显著共病问题。结果表明,报告患有慢性疼痛的 PSP 更有可能出现创伤后应激障碍(PTSD)、重度抑郁障碍、广泛性焦虑障碍、社交焦虑障碍和酒精使用障碍。在 PSP 类别之间存在差异;但是,最一致的共病迹象是慢性疼痛、PTSD 和重度抑郁障碍。PSP 中慢性疼痛和精神障碍之间的共病很普遍。医疗保健提供者应定期评估 PSP 的这两个症状领域。