Shanghai Mental Health Center, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.
Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
J Affect Disord. 2020 Jan 1;260:334-341. doi: 10.1016/j.jad.2019.08.089. Epub 2019 Aug 29.
To investigate mental and physical health comorbidity with chronic back or neck pain in the Chinese population, and assess the level of disability associated with chronic back or neck pain.
Data were derived from a large-scale and nationally representative community survey of adult respondents on mental health disorders in China (n = 28,140). Chronic back or neck pain, other chronic pain conditions and chronic physical conditions were assessed by self-report. Mental disorders were assessed by the Composite International Diagnostic Interview (CIDI). Role disability during the past 30 days was assessed with the World Health Organization Disability Assessment Schedule (WHO-DAS-II).
The 12-month prevalence of chronic back or neck pain was 10.8%. Most of respondents with chronic back or neck pain (71.2%) reported at least one other comorbid condition, including other chronic pain conditions (53.4%), chronic physical conditions (37.9%), and mental disorders (23.9%). It was found by logistic regression that mood disorders (OR = 3.7, 95%CI:2.8-4.8) showed stronger association with chronic back or neck pain than anxiety disorders and substance disorders. Most common chronic pains and physical conditions were significantly associated with chronic back or neck pain. Chronic back or neck pain was associated with role disability after controlling for demographics and for comorbidities. Physical and mental comorbidities explained 0.7% of the association between chronic back or neck pain and role disability.
Chronic back or neck pain and physical-mental comorbidity is very common in China and chronic back or neck pain may increase the likelihood of other physical and mental diseases. This presents a great challenge for both clinical treatment and public health education. We believe that further study needs to be conducted to improve the diagnostic and management skills for comorbidity conditions.
本研究旨在调查中国人群慢性腰背或颈部疼痛与精神和躯体健康共病情况，并评估慢性腰背或颈部疼痛相关的残疾程度。
本研究数据来自中国一项针对成年人群心理健康障碍的大规模全国代表性社区调查（n=28140）。慢性腰背或颈部疼痛、其他慢性疼痛状况和慢性躯体疾病通过自我报告评估。精神障碍通过复合国际诊断访谈（CIDI）评估。过去 30 天的角色残疾通过世界卫生组织残疾评估量表（WHO-DAS-II）评估。
慢性腰背或颈部疼痛的 12 个月患病率为 10.8%。大多数慢性腰背或颈部疼痛患者（71.2%）报告至少存在一种其他共病情况，包括其他慢性疼痛状况（53.4%）、慢性躯体疾病（37.9%）和精神障碍（23.9%）。Logistic 回归分析发现，心境障碍（OR=3.7，95%CI：2.8-4.8）与慢性腰背或颈部疼痛的关联强于焦虑障碍和物质使用障碍。最常见的慢性疼痛和躯体疾病与慢性腰背或颈部疼痛显著相关。在控制人口统计学特征和共病后，慢性腰背或颈部疼痛与角色残疾相关。躯体和精神共病解释了慢性腰背或颈部疼痛与角色残疾之间 0.7%的关联。
慢性腰背或颈部疼痛和躯体-精神共病在中国非常普遍，慢性腰背或颈部疼痛可能增加其他躯体和精神疾病的发生风险。这对临床治疗和公共卫生教育都提出了巨大挑战。我们认为，需要进一步研究以提高共病情况的诊断和管理技能。
