Adachi Tomonori, Yamada Keiko, Fujino Haruo, Enomoto Kiyoka, Shibata Masahiko
Graduate School of Human Development and Environment, Kobe University, Kobe, Hyogo, Japan.
Pain Management Clinic, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.
Scand J Pain. 2021 Dec 15;22(1):1-13. doi: 10.1515/sjpain-2021-0154. Print 2022 Jan 27.
Anger is a negative emotion characterized by antagonism toward someone or something, is rooted in an appraisal or attribution of wrongdoing, and is accompanied by an action tendency to undo the wrongdoing. Anger is prevalent in individuals with chronic pain, especially those with chronic primary pain. The associations between anger and pain-related outcomes (e.g., pain intensity, disability) have been examined in previous studies. However, to our knowledge, no systematic review or meta-analysis has summarized the findings of anger-pain associations through a focus on chronic primary pain. Hence, we sought to summarize the findings on the associations of anger-related variables with pain and disability in individuals with chronic primary pain.
All studies reporting at least one association between anger-related variables and the two pain-related outcomes in individuals with chronic primary pain were eligible. We searched electronic databases using keywords relevant to anger and chronic primary pain. Multiple reviewers independently screened for study eligibility, data extraction, and methodological quality assessment.
Thirty-eight studies were included in this systematic review, of which 20 provided data for meta-analyses (2,682 participants with chronic primary pain). Of the included studies, 68.4% had a medium methodological quality. Evidence showed mixed results in the qualitative synthesis. Most anger-related variables had significant positive pooled correlations with small to moderate effect sizes for pain and disability.
Through a comprehensive search, we identified several key anger-related variables associated with pain-related outcomes. In particular, associations with perceived injustice were substantial.
愤怒是一种以对某人或某事的对抗为特征的负面情绪，源于对不当行为的评估或归因，并伴有消除不当行为的行动倾向。愤怒在慢性疼痛患者中很普遍，尤其是那些患有慢性原发性疼痛的患者。先前的研究已经探讨了愤怒与疼痛相关结果（如疼痛强度、残疾）之间的关联。然而，据我们所知，尚无系统综述或荟萃分析通过关注慢性原发性疼痛来总结愤怒与疼痛关联的研究结果。因此，我们试图总结慢性原发性疼痛患者中与愤怒相关的变量与疼痛和残疾之间关联的研究结果。
所有报告至少一项慢性原发性疼痛患者中与愤怒相关的变量和两个疼痛相关结果之间关联的研究均符合条件。我们使用与愤怒和慢性原发性疼痛相关的关键词搜索电子数据库。多位评审员独立筛选研究的合格性、提取数据并评估方法学质量。
本系统综述纳入了38项研究，其中20项提供了荟萃分析的数据（2682名慢性原发性疼痛患者）。在纳入的研究中，68.4%的研究方法学质量中等。定性综合分析的证据显示结果不一。大多数与愤怒相关的变量与疼痛和残疾之间存在显著的正合并相关性，效应大小为小到中等。
通过全面搜索，我们确定了几个与疼痛相关结果相关的关键愤怒相关变量。特别是，与感知不公正的关联非常显著。
