University of Nicosia , Nicosia , Cyprus.
Department of Neurology, Medical School, University of Cyprus , Aglantzia , Nicosia , Cyprus.
Postgrad Med. 2019 Sep;131(7):438-444. doi: 10.1080/00325481.2019.1663705. Epub 2019 Sep 12.
Pain is a subjective experience that is influenced by genetics, gender, social, cultural and personal parameters. Opposed to chronic pain, which by definition has to last for at least 3 months, acute pain is mostly because of trauma, acute medical conditions or treatment. The link between mood disorders and acute pain has proven to be increasingly significant since the link is bi-directional, and both act as risk factors for each other. Depression and anxiety are associated with increased perception of pain severity, whereas prolonged duration of acute pain leads to increased mood dysregulation. Although both depression and anxiety have a proven association with acute pain, the link between depression and acute pain is more thoroughly studied. Pain can be the presenting or sole complaint in depressed patients who present to primary care practices and is often overlooked by clinicians. However, reports on the perception of experimentally-induced pain in depressed patients are mixed, showing both an increased and decreased pain threshold and pain tolerance across various studies. Although less data is published about anxiety and pain, the relationship is consistent across studies as increased anxiety leads to increased severity of pain perceived and decreased pain tolerance. Anxiety as well as fear, stress, and catastrophizing are also shown to be mediators in the causal pathway between pain and disability.
疼痛是一种主观体验，受遗传、性别、社会、文化和个人因素的影响。与定义为至少持续 3 个月的慢性疼痛相反，急性疼痛主要是由于创伤、急性疾病状况或治疗引起的。情绪障碍与急性疼痛之间的联系已被证明越来越重要，因为这种联系是双向的，两者相互作用都是对方的风险因素。抑郁和焦虑与疼痛严重程度的感知增加有关，而急性疼痛持续时间延长则会导致情绪失调增加。尽管抑郁和焦虑都与急性疼痛有明确的关联，但抑郁与急性疼痛之间的联系研究得更透彻。在到初级保健机构就诊的抑郁患者中，疼痛可能是其主要或唯一的主诉，而临床医生往往会忽视这一点。然而，关于抑郁患者对实验性疼痛感知的报告结果不一，在不同的研究中，疼痛阈值和疼痛耐受力都有增加和减少的情况。尽管关于焦虑和疼痛的研究数据较少，但焦虑与疼痛之间的关系在研究中是一致的，即焦虑增加会导致感知到的疼痛严重程度增加和疼痛耐受力降低。焦虑以及恐惧、压力和灾难化也被证明是疼痛和残疾之间因果关系中的中介因素。
