Buscemi Valentina, Chang Wei-Ju, Liston Matthew B, McAuley James H, Schabrun Siobhan M
School of Science and Health, Western Sydney University, New South Wales, Australia; Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
J Pain. 2019 Oct;20(10):1127-1139. doi: 10.1016/j.jpain.2019.02.008. Epub 2019 Feb 22.
The etiologic role of work-related psychological stress in the development of musculoskeletal pain disorders (MDs) has been systematically investigated. Less clear, however, is the role of perceived stress and life stressors. This review aimed to assess the evidence for an etiologic role of perceived stress and life stressors in the development of chronic MDs. Database searches were conducted to identify prospective longitudinal studies that assessed perceived stress and life stressors in individuals without, or in the first 6 weeks of, musculoskeletal pain. The primary outcome was the development of a chronic MD. Methodologic quality was investigated using an adapted version of the Quality Assessment Tool for Observational Cohort studies and Cross-Sectional studies, and the strength of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. Seven studies were included representing data from 6 independent cohorts. There was some evidence to support the etiologic role of perceived stress and life stressors in the development of arthritis (low quality) and chronic spinal pain (low quality). The limited number of studies, the poor quality of the evidence, and the heterogeneity of stress measures used across studies suggest that further high quality prospective studies are required to clarify the role of perceived stress and life stressors in the development of chronic MDs. PROSPERO: CRD42017059949 PERSPECTIVE: This review summarizes and critically appraises the evidence for the etiologic role of perceived stress and life stressors in the development of chronic MDs. The limited number of studies, the low quality of the evidence, and the heterogeneity across studies suggest that further research is needed on perceived stress and life stressors in MDs.
工作相关心理压力在肌肉骨骼疼痛障碍（MDs）发展中的病因学作用已得到系统研究。然而，感知压力和生活压力源的作用尚不太明确。本综述旨在评估感知压力和生活压力源在慢性MDs发展中病因学作用的证据。通过数据库检索来识别前瞻性纵向研究，这些研究评估了无肌肉骨骼疼痛个体或在肌肉骨骼疼痛最初6周内个体的感知压力和生活压力源。主要结局是慢性MDs的发生。使用观察性队列研究和横断面研究质量评估工具的改编版调查方法学质量，并使用推荐分级评估、制定和评价方法评估证据强度。纳入了7项研究，代表来自6个独立队列的数据。有一些证据支持感知压力和生活压力源在关节炎（低质量）和慢性脊柱疼痛（低质量）发展中的病因学作用。研究数量有限、证据质量差以及各研究中使用的压力测量方法的异质性表明，需要进一步开展高质量的前瞻性研究来阐明感知压力和生活压力源在慢性MDs发展中的作用。国际前瞻性系统评价注册库：CRD42017059949 观点：本综述总结并批判性评价了感知压力和生活压力源在慢性MDs发展中病因学作用的证据。研究数量有限、证据质量低以及各研究间的异质性表明，需要对MDs中的感知压力和生活压力源进行进一步研究。
