Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Neurol Sci. 2021 Feb;42(2):389-397. doi: 10.1007/s10072-020-04890-9. Epub 2020 Nov 17.
We aimed at investigating the impact of COVID-19-related distress on patients with chronic pain, highlighting the effects of changes in individual habits and public health care reconfiguration on physical and psychological health.
During the pandemic, 80 participants (25 patients with small fibre neuropathy (SFN), 42 patients with chronic migraine (CM) and 13 patients' healthy family members (HFM)) were asked to evaluate their COVID-19 complains, changes in habits and clinical management, behaviour, mood, loneliness, quality of life (QoL), physical and mental health and coping strategies. Data were analysed by Spearman rho correlations and Mann-Whitney U tests.
Patients had lower QoL, lower physical health and higher catastrophizing attitude towards pain than HFM. During the pandemic, SFN patients referred greater decline in clinical symptoms, worries about contagion and discomfort for disease management changes than CM patients. In the SFN group, the higher levels of disability were associated with suffering from changes in neurologist-patient relationship. CM patients complained of agitation/anxiety that was related to feelings of loneliness, depressive mood and catastrophism.
Despite similar complains of change in habits and worries about COVID-19 pandemic, SFN and CM patients had distinct reactions. In SFN patients, pandemic distress impacted on physical health with worsening of clinical conditions, especially suffering from changes in their care. In CM patients, pandemic distress affected behaviour, mainly with psychological frailty. This suggests the need to customize public health care for patients with distinct chronic pain conditions.
本研究旨在探讨 COVID-19 相关困扰对慢性疼痛患者的影响，强调个体习惯改变和公共卫生保健配置变化对身心健康的影响。
在疫情期间，80 名参与者（25 名小纤维神经病（SFN）患者、42 名慢性偏头痛（CM）患者和 13 名健康家庭成员（HFM））被要求评估他们的 COVID-19 投诉、习惯和临床管理变化、行为、情绪、孤独感、生活质量（QoL）、身心健康和应对策略。采用 Spearman rho 相关分析和 Mann-Whitney U 检验对数据进行分析。
与 HFM 相比，患者的 QoL 更低，身体健康状况更差，对疼痛的灾难化态度更高。在疫情期间，SFN 患者比 CM 患者报告临床症状、对感染的担忧和对疾病管理变化的不适更严重。在 SFN 组中，残疾程度越高与神经病学家-患者关系的变化有关。CM 患者抱怨烦躁/焦虑，与孤独感、抑郁情绪和灾难化有关。
尽管 SFN 和 CM 患者对习惯改变和对 COVID-19 大流行的担忧相似，但他们的反应却截然不同。在 SFN 患者中，大流行的困扰对身体健康产生了影响，导致临床状况恶化，尤其是对护理变化的不适。在 CM 患者中，大流行的困扰影响了行为，主要是心理脆弱。这表明需要为具有不同慢性疼痛状况的患者定制公共卫生保健。
