Underwood Mandy, Bonas Sheila, Dale Maria
Department of Clinical Psychology University of Leicester Leicester United Kingdom.
Leicester Partnership National Health Service Trust Leicester United Kingdom.
Mov Disord Clin Pract. 2016 Jun 6;4(2):198-204. doi: 10.1002/mdc3.12376. eCollection 2017 Mar-Apr.
Huntington's disease (HD) is a genetic neurodegenerative condition that involves impairments in movement, cognition, and mood. Research is lacking in HD with regard to the prevalence of pain and the relationships between psychological factors and pain. The aim of this research was to investigate the prevalence of pain and identify the psychological factors associated with pain severity in people with HD.
This data-mining study used data from 1474 people who participated in the European Huntington's Disease Network (EHDN) REGISTRY study. Pain severity was measured using the Medical Outcome Study 36-item short-form health survey. Separate ordinal regression analyses were conducted with participant-rated and interviewer-rated psychological measures (the Hospital Anxiety and Depression Scale-Snaith Irritability Scale and the Unified Huntington's Disease Rating Scale). The psychological factors considered were anxiety, depression, irritability, aggression, low self-esteem, and apathy.
The prevalence of pain in the total sample was 41% (stage I, 42%; stage II, 44%; stage III, 39%; stages IV and V, 50%). After controlling for confounding variables, pain severity was significantly associated with participant-rated anxiety and depression. Interviewer-rated anxiety, depression, and irritability also were significantly associated with severity of pain after controlling for confounding variables.
This research confirmed that pain is indeed an issue for people with HD, particularly during the later stages of the disease. Caregivers and health professionals should consider the possibility that people with HD might be experiencing pain, particularly if they are showing signs of anxiety, depression, or irritability.
亨廷顿舞蹈症(HD)是一种遗传性神经退行性疾病,会导致运动、认知和情绪障碍。关于HD患者疼痛的患病率以及心理因素与疼痛之间的关系,目前研究较少。本研究的目的是调查HD患者疼痛的患病率,并确定与疼痛严重程度相关的心理因素。
这项数据挖掘研究使用了参与欧洲亨廷顿舞蹈症网络(EHDN)注册研究的1474人的数据。疼痛严重程度采用医学结局研究36项简短健康调查问卷进行测量。分别使用参与者自评和访谈者评定的心理测量工具(医院焦虑抑郁量表-斯奈斯易怒量表和统一亨廷顿舞蹈症评定量表)进行有序回归分析。所考虑的心理因素包括焦虑、抑郁、易怒、攻击性、自卑和冷漠。
总样本中疼痛的患病率为41%(I期,42%;II期,44%;III期,39%;IV期和V期,50%)。在控制混杂变量后,疼痛严重程度与参与者自评的焦虑和抑郁显著相关。在控制混杂变量后,访谈者评定的焦虑、抑郁和易怒也与疼痛严重程度显著相关。
本研究证实疼痛确实是HD患者面临的一个问题,尤其是在疾病后期。护理人员和卫生专业人员应考虑HD患者可能正在经历疼痛的可能性,特别是当他们表现出焦虑、抑郁或易怒迹象时。