Department of Anesthesia & Perioperative Medicine, Max Rady College of Medicine, University of Manitoba, 2nd Floor Harry Medovy House, 671 William Avenue, Winnipeg, MB, R3E 0Z2, Canada.
Department of Anesthesia & Perioperative Medicine, Max Rady College of Medicine, University of Manitoba, 2nd Floor Harry Medovy House, 671 William Avenue, Winnipeg, MB, R3E 0Z2, Canada; Department of Psychology, Faculty of Arts, University of Manitoba, P404 Duff Roblin Building, 190 Dysart Road, Winnipeg, MB, R3T 2N2 Canada.
J Anxiety Disord. 2018 May;56:74-80. doi: 10.1016/j.janxdis.2018.04.005. Epub 2018 Apr 17.
This study aimed to: 1) Establish the prevalence of co-occurring chronic pain conditions (i.e., arthritis, back pain, and migraines) and generalized anxiety disorder (GAD), and 2) Examine levels of pain severity, disability, and work absenteeism among comorbid chronic pain conditions and GAD.
Data were analyzed from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH; N = 25,113). Chi-square analyses assessed whether significant differences existed in pain severity in those with comorbid chronic pain and GAD versus pain conditions alone. Multivariable regressions examined the association between comorbid chronic pain and GAD with functional outcomes.
The weighted prevalence of GAD among those with chronic migraines, arthritis and back pain was 6.9%, 4.4%, and 6.1% respectively, compared to 2.6% among the entire sample. Severity of pain was increased among those with comorbid chronic pain and GAD compared with chronic pain conditions alone. Migraine was the only pain condition that was significantly associated with disability in our most stringent adjustment model. After controlling for other psychiatric disorders, comorbid GAD and chronic pain was not associated with work absenteeism.
Chronic pain is common among the Canadian population and is associated with substantial disability. Results demonstrated that GAD is prevalent among chronic pain conditions, and comorbidity is associated with greater pain severity. GAD in the context of migraines, in particular, may represent an important treatment target to reduce disability.
本研究旨在：1）确定共患慢性疼痛疾病（即关节炎、背痛和偏头痛）和广泛性焦虑症（GAD）的患病率，2）检查共患慢性疼痛疾病和 GAD 患者的疼痛严重程度、残疾和旷工水平。
对 2012 年加拿大社区健康调查-心理健康（CCHS-MH；N=25113）的数据进行了分析。卡方分析评估了共患慢性疼痛和 GAD 与单纯疼痛疾病患者之间疼痛严重程度是否存在显著差异。多变量回归检查了共患慢性疼痛和 GAD 与功能结果之间的关联。
与整个样本中的 2.6%相比，患有慢性偏头痛、关节炎和背痛的患者中 GAD 的加权患病率分别为 6.9%、4.4%和 6.1%。与单纯慢性疼痛疾病患者相比，共患慢性疼痛和 GAD 的患者疼痛严重程度增加。偏头痛是我们最严格调整模型中唯一与残疾显著相关的疼痛疾病。在控制其他精神障碍后，共患 GAD 和慢性疼痛与旷工无关。
慢性疼痛在加拿大人群中很常见，并且与严重残疾有关。结果表明，GAD 在慢性疼痛疾病中很常见，共病与更严重的疼痛有关。特别是偏头痛伴 GAD 可能是减少残疾的一个重要治疗目标。
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