Twiddy Hannah, Frank Bernhard, Alam Uazman
Department of Pain Medicine, The Walton Centre, Liverpool, UK.
Diabetes and Endocrinology Research, Institute of Cardiovascular and Metabolic Medicine and The Pain Research Institute, University of Liverpool and Liverpool University NHS Hospital Trust, Liverpool, UK.
Diabetes Ther. 2021 Feb;12(2):487-498. doi: 10.1007/s13300-020-00983-y. Epub 2020 Dec 26.
Painful diabetic neuropathy (pDN) is characterised by both sensory and affective disturbances, suggesting a complex bidirectional relationship of neuropathic pain and mood disorders. Data on pDN indicate that neuropathic pain reduces quality of life, including mood and physical and social functioning. Depression and pain coping strategies such as catastrophising and social support predict pain severity. There is a significant and reciprocal relationship between depressed mood and increased pain. The key features of assessing people with neuropathic pain in relation to psychological aspects of their health are discussed in the context of management in a tertiary pain management centre (The Walton Centre, Liverpool, UK) including cognitive behavioural interventions amongst others to improve the quality of life in patients with pDN. We consider psychological issues as a factor influencing treatment and outcome in patients with pDN.
疼痛性糖尿病神经病变（pDN）的特征是感觉和情感障碍，提示神经病理性疼痛与情绪障碍之间存在复杂的双向关系。关于pDN的数据表明，神经病理性疼痛会降低生活质量，包括情绪、身体和社会功能。抑郁以及诸如灾难化和社会支持等疼痛应对策略可预测疼痛严重程度。抑郁情绪与疼痛加剧之间存在显著的相互关系。在三级疼痛管理中心（英国利物浦的沃尔顿中心）的管理背景下，讨论了在评估患有神经病理性疼痛的患者时，与其健康心理方面相关的关键特征，包括认知行为干预等，以改善pDN患者的生活质量。我们认为心理问题是影响pDN患者治疗和预后的一个因素。
