Patel Sneh, Felix Elizabeth R, Levitt Roy C, Sarantopoulos Constantine D, Galor Anat
Ophthalmology and Research Services, Miami Veterans Affairs (VA) Medical Center, Miami, FL 33125, USA.
Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA.
J Clin Med. 2019 Jun 24;8(6):901. doi: 10.3390/jcm8060901.
Dysfunctional coping behaviors, such as catastrophizing, have been implicated in pain severity and chronicity across several pain disorders. However, the impact of dysfunctional coping has not been examined under the context of dry eye (DE). This study evaluates relationships between catastrophizing and measures of DE, including pain severity and pain-related daily interference. The population consisted of patients seen at Miami Veterans Affairs eye clinic between April 2016 and October 2017. Patients filled out standardized questionnaires assessing symptoms of DE and eye pain, non-ocular pain, mental health, coping behaviors (Pain Catastrophizing Scale, PCS), and pain-related daily interference as a perceived impact on quality of life (Multidimensional Pain Inventory, Interference Subscale, MPI-Interference), and all patients underwent an ocular surface examination. In total, 194 patients participated, with a mean age of 58.8 ± 9.6 years, the majority being male, non-Hispanic, and black. PCS (catastrophizing) was correlated with DE symptom severity, including Dry-Eye Questionnaire 5 (DEQ5; r = 0.41, < 0.0005), Ocular Surface Disease Index (OSDI; r = 0.40, < 0.0005), and neuropathic-like eye pain (Neuropathic Pain Symptom Inventory-Eye (NPSI-Eye; r = 0.48, < 0.0005). Most tear metrics, on the other hand, did not correlate with PCS. Linear regressions showed that PCS, non-ocular pain intensity, and number of pain conditions were significant predictors of DEQ5 (overall DE symptoms), while PCS and non-ocular pain intensity were predictors of NPSI-Eye scores, as were insomnia scores and analgesic use. In a separate analysis, PCS and DE symptoms (OSDI) associated with pain-related interference (MPI-Interference) along with non-ocular pain intensity, post-traumatic stress disorder (PTSD), number of pain conditions, and non-Hispanic ethnicity. These findings suggest that catastrophizing is not significantly related to signs of DE, but is strongly associated to pain-related symptoms of DE and daily interference due to pain.
功能失调的应对行为，如灾难化思维，在多种疼痛性疾病的疼痛严重程度和慢性化过程中都有涉及。然而，功能失调的应对方式在干眼症（DE）背景下的影响尚未得到研究。本研究评估了灾难化思维与干眼症相关指标之间的关系，包括疼痛严重程度和与疼痛相关的日常干扰。研究对象为2016年4月至2017年10月期间在迈阿密退伍军人事务部眼科诊所就诊的患者。患者填写了标准化问卷，评估干眼症和眼痛、非眼部疼痛、心理健康、应对行为（疼痛灾难化量表，PCS）以及作为对生活质量的感知影响的与疼痛相关的日常干扰（多维疼痛问卷，干扰分量表，MPI-干扰），所有患者均接受了眼表检查。共有194名患者参与，平均年龄为58.8±9.6岁，大多数为男性、非西班牙裔和黑人。PCS（灾难化思维）与干眼症症状严重程度相关，包括干眼问卷5（DEQ5；r = 0.41，<0.0005）、眼表疾病指数（OSDI；r = 0.40，<0.0005）以及神经性眼痛（神经性疼痛症状量表-眼部（NPSI-眼部；r = 0.48，<0.0005）。另一方面，大多数泪液指标与PCS无关。线性回归显示，PCS、非眼部疼痛强度和疼痛状况数量是DEQ5（总体干眼症症状）的显著预测因素，而PCS和非眼部疼痛强度是NPSI-眼部评分的预测因素，失眠评分和镇痛药物使用情况也是如此。在另一项分析中，PCS和与疼痛相关干扰（MPI-干扰）相关的干眼症症状（OSDI）以及非眼部疼痛强度、创伤后应激障碍（PTSD）、疼痛状况数量和非西班牙裔种族有关。这些发现表明，灾难化思维与干眼症体征无显著相关性，但与干眼症的疼痛相关症状及疼痛导致的日常干扰密切相关。
