Fujimoto Koji, Hosoi Masako, Katsuki Ryoko, Matsushima Toshio, Matsuo Keitaro, Nakao Tomohiro, Sudo Nobuyuki, Kato Takahiro A
Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.
Front Psychiatry. 2022 Feb 10;13:825422. doi: 10.3389/fpsyt.2022.825422. eCollection 2022.
Modern-Type Depression (MTD) is a category of depression that has been studied mainly in Japan; however, no study has attempted to determine its relation to chronic pain.
To determine possible associations between psychological traits related to MTD and the chronic pain of patients at psychiatric clinics.
Two hundred and twenty-one first time patients who visited the psychiatric clinic at a Japanese university medical center or an associated clinic were enrolled. The Hamilton Depression Rating Scale was used to measure depressive symptoms. The 22-item Tarumi's Modern-Type Depression Trait Scale (TACS-22), Achievement Motive, and 20-item Toronto Alexithymia Scale were used to assess psychological traits related to depression and chronic pain. The clinical diagnosis of each patient was confirmed by use of the Structured Clinical Interview for DSM-IV Axis I Disorders, administered by experienced specialists. The medians of the psychological traits identified were compared between patients with or without chronic pain. Analysis was also done of patients with Major Depressive Disorder (MDD).
Of the 221 patients, 139 had chronic pain. Patients with chronic pain had more severe depressive symptoms, Alexithymia, and high scores for the complaint trait of MTD. Seventy-three of the 221 patients met the criteria for MDD (53 had chronic pain). Patients with MDD comorbid with chronic pain had a higher competitive achievement score, severe depression, and difficulty identifying feelings.
Complaint and competitive traits were shown to be related to chronic pain in psychiatric settings. Further study will allow us to design multidimensional approach for patients suffering from depression.
现代型抑郁症（MTD）是一类主要在日本进行研究的抑郁症；然而，尚无研究试图确定其与慢性疼痛的关系。
确定与MTD相关的心理特质与精神科门诊患者慢性疼痛之间的可能关联。
招募了221名首次前往日本大学医学中心精神科门诊或相关诊所就诊的患者。使用汉密尔顿抑郁量表来测量抑郁症状。采用22项Tarumi现代型抑郁特质量表（TACS - 22）、成就动机量表和20项多伦多述情障碍量表来评估与抑郁和慢性疼痛相关的心理特质。每位患者的临床诊断由经验丰富的专家通过使用《精神疾病诊断与统计手册》第四版轴I障碍结构化临床访谈来确认。比较有或无慢性疼痛患者所确定的心理特质的中位数。还对重度抑郁症（MDD）患者进行了分析。
221名患者中，139名有慢性疼痛。有慢性疼痛的患者有更严重的抑郁症状、述情障碍，且MTD的抱怨特质得分更高。221名患者中有73名符合MDD标准（53名有慢性疼痛）。合并慢性疼痛的MDD患者有更高的竞争成就得分、严重抑郁，且难以识别情感。
在精神科环境中，抱怨和竞争特质与慢性疼痛有关。进一步的研究将使我们能够为抑郁症患者设计多维度治疗方法。
