Department of Otolaryngology/Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, U.S.A.
Laryngoscope. 2021 Sep;131(9):1939-1945. doi: 10.1002/lary.29405. Epub 2021 Jan 29.
OBJECTIVES/HYPOTHESIS: Psychological comorbidity is common in patients with chronic rhinosinusitis (CRS) and is correlated with decreased overall and disease-specific quality of life (QoL). Prior research reported that anxiety and depression, as measured by the hospital anxiety and depression scale (HADS), are associated with worse CRS-specific QoL, as assessed via the Rhinosinusitis Disability Index (RSDI). Furthermore, patients prone to anxiety/depression may display an exaggerated response to real or anticipated discomfort; the pain catastrophizing scale (PCS) is a validated instrument designed to measure this phenomenon. This study is intended to explore the role of pain catastrophizing in relation to anxiety, depression, and disease-specific QoL in patients with facial pain attributed to CRS.
Prospective cohort study.
Diagnosis of presumed CRS was based upon current American Academy of Otolaryngology - Head & Neck Surgery (AAO-HNS) guidelines; all participants reported facial pain as a component of their CRS symptomatology. RSDI, HADS, and PCS questionnaires were administered upon presentation prior to intervention, and objective measurements of sinonasal inflammation were obtained via nasal endoscopy and computed tomography (CT).
Seventy-five patients were enrolled in the study. Significant positive correlations were found between PCS and HADS, total RSDI, and RSDI emotional sub-scores (P < .05). The incidence of objective evidence of disease, as measured via nasal endoscopy and CT, was not significantly different in catastrophizing patients.
Pain catastrophizing correlates with anxiety/depression and worse disease-specific QoL in patients meeting symptomatic criteria for CRS. Otolaryngologists should be aware that catastrophic thinking can intensify a patient's perception of sinonasal symptoms, and clinicians may consider management of psychological comorbidity to optimize rhinologic outcomes.
4 Laryngoscope, 131:1939-1945, 2021.
目的/假设：慢性鼻-鼻窦炎（CRS）患者常伴有心理共病，且与整体和疾病特异性生活质量（QoL）下降相关。既往研究显示，采用医院焦虑抑郁量表（HADS）评估的焦虑和抑郁与更差的 CRS 特异性 QoL 相关，而采用鼻-鼻窦炎生活质量调查问卷（RSDI）评估的结果也是如此。此外，易患焦虑/抑郁的患者可能对真实或预期的不适表现出过度反应；疼痛灾难化量表（PCS）是一种经过验证的测量这种现象的工具。本研究旨在探讨疼痛灾难化与 CRS 相关面部疼痛患者的焦虑、抑郁和疾病特异性 QoL 的关系。
前瞻性队列研究。
根据当前美国耳鼻喉科学-头颈外科学会（AAO-HNS）指南诊断疑似 CRS；所有参与者均报告面部疼痛是其 CRS 症状的一部分。在干预前就诊时，对 RSDI、HADS 和 PCS 问卷进行了评估，并通过鼻内镜和计算机断层扫描（CT）获得了鼻-鼻窦炎症的客观测量结果。
本研究共纳入 75 例患者。PCS 与 HADS、总 RSDI 和 RSDI 情绪子评分呈显著正相关（P<.05）。根据鼻内镜和 CT 评估，在灾难化患者中，疾病的客观证据发生率无显著差异。
在符合 CRS 症状标准的患者中，疼痛灾难化与焦虑/抑郁和更差的疾病特异性 QoL 相关。耳鼻喉科医生应该意识到灾难性思维会加剧患者对鼻-鼻窦症状的感知，临床医生可能需要考虑处理心理共病以优化鼻科结局。
4 Laryngoscope, 131:1939-1945, 2021.
