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人格特质调节艺术干预对阿尔茨海默病患者慢性疼痛的疗效。

Personality Modulates the Efficacy of Art Intervention on Chronic Pain in a Population of Patients with Alzheimer's Disease.

机构信息

Memory Clinical and Research Center of Saint Etienne (CMRR) Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France.

Memory Clinical and Research Center of Lyon (CMRR), Hospital of Charpennes, University Hospital of Lyon, France.

出版信息

J Alzheimers Dis. 2018;63(2):617-624. doi: 10.3233/JAD-170990.

Abstract

BACKGROUND

Alzheimer's disease (AD) mainly occurs in elderly individuals. Comorbidities and chronic pain are frequent in this population. Previous studies revealed that personality modulates both chronic pain (CP) andADoccurrence and evolution. Moreover, as pain treatments can induce side-effects, non-drugs treatments, such as art interventions, are interesting alternative therapies for decreasing CP in these patients.

OBJECTIVE

Our aim was to assess the potential role of personality traits on art intervention efficacy for reducing CP in a population of patients with mild AD.

METHODS

Design: multicenter randomized controlled trial. Fifty mild AD patients underwent a 12-week art intervention including singing and painting groups. Personality was assessed with the Big Five Inventory before the sessions. CP was measured with Numeric Rating Scale (NRS) [Usual pain (NRS-U) and most Intense pain (NRS-I)], Simple Visual Scale [Usual pain (SVS-U) and most Intense pain (SVS-I)] and Brief Pain Inventory (BPI) before and after the sessions. The influence of personality traits on CP evolution before and after art intervention was assessed with multiple linear regression models.

RESULTS

A positive association was observed between neuroticism and the evolution of three CP measures including NRS-U (B = 0.34, p = 0.01), SVS-U (B = 0.20, p = 0.04), and BPI-U (B = 0.46, p = 0.02) evolution. No significant relationship was observed between neuroticism and NRS-I, SVS-I and BPI-R evolution.

CONCLUSIONS

Our findings suggest that neuroticism can decrease the efficacy of group art intervention on pain in patients with mild AD. Individual therapies could be more appropriate for these patients. These results emphasize the interest of taking into account patients' personality before proposing them to participate to a group therapy.

摘要

背景

阿尔茨海默病(AD)主要发生在老年人中。该人群常合并多种疾病和慢性疼痛。先前的研究表明,人格既调节慢性疼痛(CP)的发生和发展,也调节 AD 的发生和发展。此外,由于疼痛治疗可能会产生副作用,因此艺术干预等非药物治疗对于减少这些患者的 CP 是一种有趣的替代疗法。

目的

我们旨在评估人格特质在轻度 AD 患者群体中艺术干预减轻 CP 中的潜在作用。

方法

设计:多中心随机对照试验。50 例轻度 AD 患者接受为期 12 周的艺术干预,包括唱歌和绘画组。在治疗前使用大五人格量表评估人格。使用数字评分量表(NRS)[常规疼痛(NRS-U)和最剧烈疼痛(NRS-I)]、简易视觉量表[常规疼痛(SVS-U)和最剧烈疼痛(SVS-I)]和简明疼痛量表(BPI)在治疗前后测量 CP。使用多元线性回归模型评估人格特质对艺术干预前后 CP 变化的影响。

结果

发现神经质与 NRS-U(B = 0.34,p = 0.01)、SVS-U(B = 0.20,p = 0.04)和 BPI-U(B = 0.46,p = 0.02)的三个 CP 测量指标的变化呈正相关。神经质与 NRS-I、SVS-I 和 BPI-R 的变化无显著相关性。

结论

我们的研究结果表明,神经质可能会降低小组艺术干预对轻度 AD 患者疼痛的疗效。对于这些患者,个体治疗可能更为合适。这些结果强调了在向患者提出参加小组治疗之前,考虑患者个性的重要性。

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