School of Psychology, University College Dublin, Dublin, Ireland.
School of Psychology, University College Dublin, Dublin, Ireland.
J Pain. 2021 Jun;22(6):643-654. doi: 10.1016/j.jpain.2020.12.009. Epub 2021 Jan 16.
Perceived injustice is increasingly recognized as a risk factor for problematic recovery, with a growing body of evidence documenting its association with heightened pain, disability, medication use, anger and post-traumatic stress. The aim of this paper was to systematically review and critically appraise the association between perceived injustice and depressive symptomatology across a wide range of medical and mental health populations, including acute and chronic pain samples. A search of published, English language studies in the PubMed, EMBASE, CINAHL, and PsycINFO databases from 1990 to June 2020 was performed. Thirty-three studies met inclusion criteria with a total sample of 5,425 individuals (61% female), primarily with acute injury or chronic pain. Results indicated a moderate to strong positive association between perceived injustice and depressive symptomatology (meta-analysis pooled effect of r = .57, 95% confidence interval [.55, .58], P< .001). A narrative synthesis of regression models indicated standardized beta coefficients between .19 and .66, with perceived injustice consistently contributing significant unique variance to the prediction of depression in final regression equations. Selection bias and response bias were common limitations in the studies. The clinical implications of an association between injustice and depression in acute and chronic pain are discussed. PROSPERO: CRD42019143465. PERSPECTIVE: This review demonstrates that in acute injury and chronic pain samples, perceived injustice is associated with depression. These findings could help clinicians in the field of pain and rehabilitation identify who may be at greater risk for a problematic recovery trajectory.
感知到的不公正日益被认为是导致康复问题的一个风险因素，越来越多的证据表明，它与疼痛加剧、残疾、药物使用、愤怒和创伤后应激有关。本文的目的是系统地回顾和批判性评估感知不公正与广泛的医疗和心理健康人群（包括急性和慢性疼痛样本）中抑郁症状之间的关联。在 PubMed、EMBASE、CINAHL 和 PsycINFO 数据库中搜索了 1990 年至 2020 年 6 月发表的英文研究。有 33 项研究符合纳入标准，总样本量为 5425 人（61%为女性），主要为急性损伤或慢性疼痛患者。结果表明，感知不公正与抑郁症状之间存在中度至高度的正相关（荟萃分析合并 r=0.57，95%置信区间 [0.55，0.58]，P<0.001）。对回归模型的叙述性综合分析表明，标准化β系数在 0.19 到 0.66 之间，感知不公正始终对抑郁的预测有显著的独特贡献。在这些研究中，选择偏倚和反应偏倚是常见的局限性。讨论了急性和慢性疼痛中不公正与抑郁之间关联的临床意义。PROSPERO：CRD42019143465。观点：本综述表明，在急性损伤和慢性疼痛样本中，感知不公正与抑郁有关。这些发现可以帮助疼痛和康复领域的临床医生识别哪些人可能有更大的问题康复轨迹风险。
