Sánchez-Rodríguez Elisabet, Aragonès Enric, Jensen Mark P, Tomé-Pires Catarina, Rambla Concepció, López-Cortacans Germán, Miró Jordi
Department of Psychology, Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Catalonia, Spain.
Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain.
Pain Med. 2020 Oct 1;21(10):2200-2211. doi: 10.1093/pm/pnz363.
The aims of this study were twofold: 1) to better understand the associations between pain-related cognitions and pain severity, and psychological and physical function, and 2) to determine the extent to which these cognitions function as mediators in the association between pain severity and depression in a sample of primary care adult patients with chronic pain and depression.
Cross-sectional design.
Three hundred twenty-eight patients with both depression and chronic pain from primary care centers responded to measures of pain severity, pain interference, depression severity, and pain-related cognitions (including measures of catastrophizing and other pain-related beliefs). We performed three hierarchical regression analyses and two multiple regression analyses.
The helplessness domain of pain catastrophizing was positively associated with pain severity, depression severity, and pain interference and mediated the relationship between depression and pain severity and vice versa. Beliefs about disability showed a positive association with pain severity, pain interference, and depression severity, and also mediated the relationship between pain severity and depression. Believing in a medical cure was positively associated with pain interference and negatively associated with depression; emotion beliefs were positively associated with pain severity.
These findings provide important new information about the associations between several pain-related cognitions and pain severity, depression, and pain interference and the potential mediating roles that these cognitions play in the associations between pain severity and depression in patients with both chronic pain and depression in the primary care setting.
本研究有两个目的：1）更好地理解疼痛相关认知与疼痛严重程度、心理和生理功能之间的关联；2）确定在初级保健成年慢性疼痛和抑郁症患者样本中，这些认知在疼痛严重程度与抑郁之间的关联中作为中介的程度。
横断面设计。
来自初级保健中心的328名同时患有抑郁症和慢性疼痛的患者对疼痛严重程度、疼痛干扰、抑郁严重程度以及疼痛相关认知（包括灾难化和其他疼痛相关信念的测量）进行了回答。我们进行了三次分层回归分析和两次多元回归分析。
疼痛灾难化的无助感领域与疼痛严重程度、抑郁严重程度和疼痛干扰呈正相关，并介导了抑郁与疼痛严重程度之间的关系，反之亦然。关于残疾的信念与疼痛严重程度、疼痛干扰和抑郁严重程度呈正相关，并且也介导了疼痛严重程度与抑郁之间的关系。相信医学治愈与疼痛干扰呈正相关，与抑郁呈负相关；情绪信念与疼痛严重程度呈正相关。
这些发现提供了重要的新信息，涉及几种疼痛相关认知与疼痛严重程度、抑郁和疼痛干扰之间的关联，以及这些认知在初级保健环境中慢性疼痛和抑郁症患者的疼痛严重程度与抑郁之间的关联中所起的潜在中介作用。
