Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Primary Health Care Unit, Kuopio, Finland, Phone: +358407063831.
University of Helsinki and Helsinki University Hospital; Psychiatry, Helsinki, Finland.
Scand J Pain. 2020 Jul 28;20(3):603-610. doi: 10.1515/sjpain-2019-0128.
Background and aims Restless legs syndrome is a sensorimotor disorder associated with mental health conditions notably depression. Restless legs symptoms and depression are commonly associated with pain. The study investigated the influence of restless legs symptoms on musculoskeletal pain in patients with depression or with increased depressive symptoms. Methods A cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in patients with depressive symptoms (n = 695) and controls without a psychiatric diagnosis (n = 410) by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory and the psychiatric diagnosis was confirmed by means of a diagnostic interview (MINI). The prevalence and intensity of musculoskeletal pain was captured with form-based questions. A single-question screen for restless legs symptoms was applied. Results There was a significant difference in the prevalence of continuous widespread musculoskeletal pain between the three study groups: the controls 4.6% (95% CI: 2.8-7.1), the patients with symptoms of depression without a diagnosis 16.0% (11.7-21.1), and the patients with diagnosed depression 22.1% (18.3-23.3) (p = 0.006 after being adjusted for age, sex, smoking, use of alcohol, education years, body mass index, use of antidepressants, and physical activity, after multiple corrections, all groups were significantly different from each other). Compared with those not having restless legs symptoms, subjects with restless legs symptoms had more often continuous widespread musculoskeletal pain in the control subjects (p = 0.001; 2.3% vs. 10.5%) and in the patients with depressive symptoms without a depression diagnosis (p = 0.024; 9.1 vs. 18.7%) but not in those with diagnosed depression (p = 0.98; 19.5 vs. 19.4%). The restless legs symptoms were associated with the intensity of pain in all groups (p < 0.001). Conclusions Restless legs symptoms were related to continuous widespread musculoskeletal pain in subjects without depressive symptoms and in patients with depressive symptoms without a depression diagnosis. Pain intensity was higher in the subjects with restless legs symptoms regardless of depressive symtoms or depression. Implications Clinical management of pain in patients with restless legs symptoms should include an increased focus on the prevention and treatment of either conditions.
不宁腿综合征是一种与心理健康状况相关的感觉运动障碍，尤其是抑郁症。不宁腿症状和抑郁通常与疼痛相关。本研究旨在调查不宁腿症状对抑郁症或抑郁症状加重患者的肌肉骨骼疼痛的影响。
这是一项横断面研究，在芬兰中部医院区的初级保健患者中进行。使用结构化问卷，在具有抑郁症状的患者（n=695）和无精神科诊断的对照组（n=410）中研究不宁腿症状的患病率。使用贝克抑郁量表评估抑郁症状，通过迷你国际神经精神访谈（MINI）确认精神科诊断。使用基于表格的问题捕获肌肉骨骼疼痛的患病率和强度。应用一个不宁腿症状的单问题筛查。
三组患者的连续广泛肌肉骨骼疼痛患病率存在显著差异：对照组为 4.6%（95%CI：2.8-7.1），有抑郁症状但无诊断的患者为 16.0%（11.7-21.1），有诊断为抑郁症的患者为 22.1%（18.3-23.3）（在调整年龄、性别、吸烟、饮酒、教育年限、体重指数、使用抗抑郁药和体力活动后，p=0.006，多重校正后，所有组之间均有显著差异）。与无不宁腿症状的患者相比，有不宁腿症状的患者在对照组（p=0.001；2.3% vs. 10.5%）和有抑郁症状但无诊断的患者（p=0.024；9.1% vs. 18.7%）中更常出现连续广泛的肌肉骨骼疼痛，但在诊断为抑郁症的患者中则无显著差异（p=0.98；19.5% vs. 19.4%）。不宁腿症状与所有组的疼痛强度相关（p<0.001）。
不宁腿症状与无抑郁症状的患者和有抑郁症状但无诊断的患者的连续广泛肌肉骨骼疼痛有关。有不宁腿症状的患者的疼痛强度更高，无论是否存在抑郁症状或抑郁症。
临床管理不宁腿症状患者的疼痛时，应更加重视这两种疾病的预防和治疗。
