Gao Hua, Xia Qingrong, Zhang Xulai, Chen Yuanyuan, Yan Junwei, Gao Jianliang, Zhang Loufeng, Zhang Jie, Wang Keming, Li Chao, Ju Peijun, Zhu Cuizhen
Anhui Clinical Research Center for Mental Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, Anhui, China.
Common Psychiatry Department, Hefei Fourth People's Hospital, Hefei, Anhui, China.
Gen Psychiatr. 2023 Feb 22;36(1):e100895. doi: 10.1136/gpsych-2022-100895. eCollection 2023.
Patients who suffer comorbidity of major depressive disorder (MDD) and chronic pain (CP) maintain a complex interplay between maladaptive prospective memory (PM) and retrospective memory (RM) with physical pain, and their complications are still unknown.
We aimed to focus on the full cognitive performance and memory complaints in patients with MDD and CP, patients with depression without CP, and control subjects, considering the possible influence of depressed affect and chronic pain severity.
According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the criteria given by the International Association of Pain, a total of 124 participants were included in this cross-sectional cohort study. Among them, 82 depressed inpatients and outpatients from Anhui Mental Health centre were divided into two groups: a comorbidity group(patients with MDD and CP) (n=40) and a depression group (patients with depression without CP) (n=42). Meanwhile, 42 healthy controls were screened from the hospital's physical examination centre from January 2019 to January 2022. The Hamilton Depression Rating Scale-24 (HAMD-24) and Beck Depression Inventory-II (BDI-II) were used to evaluate the severity of depression. The Pain Intensity Numerical Rating Scale (PI-NRS), Short-Form McGill Pain Questionnaire-2 Chinese version (SF-MPQ-2-CN), Montreal Cognitive Assessment-Basic Section (MoCA-BC), and Prospective and Retrospective Memory Questionnaire (PRMQ) were used to assess pain-related features and the global cognitive functioning of study participants.
The impairments in PM and RM differed remarkably among the three groups (F=7.221, p<0.001; F=7.408, p<0.001) and were severe in the comorbidity group. Spearman correlation analysis revealed the PM and RM were positively correlated with continuous pain and neuropathic pain (r=0.431, p<0.001; r=0.253, p=0.022 and r=0.415, p<0.001; r=0.247, p=0.025), respectively. Regression analysis indicated a significant positive relationship between affective descriptors and total BDI-II score (β=0.594, t=6.600, p<0.001). Examining the mediator pathways revealed the indirect role of PM and RM in patients with comorbid MDD and CP.
Patients with comorbid MDD and CP presented more PM and RM impairments than patients with MDD without CP. PM and RM are possibly mediating factors that affect the aetiology of comorbid MDD and CP.
chiCTR2000029917.
患有重度抑郁症（MDD）和慢性疼痛（CP）共病的患者在适应不良的前瞻性记忆（PM）和回顾性记忆（RM）与身体疼痛之间维持着复杂的相互作用，且它们的并发症仍不明确。
考虑到抑郁情绪和慢性疼痛严重程度的可能影响，我们旨在关注MDD和CP患者、无CP的抑郁症患者以及对照受试者的全面认知表现和记忆主诉。
根据《精神障碍诊断与统计手册》第五版以及国际疼痛协会给出的标准，本横断面队列研究共纳入124名参与者。其中，来自安徽精神卫生中心的82名抑郁住院患者和门诊患者被分为两组：共病组（MDD和CP患者）（n = 40）和抑郁症组（无CP的抑郁症患者）（n = 42）。同时，2019年1月至2022年1月期间从医院体检中心筛选出42名健康对照。采用汉密尔顿抑郁量表24项（HAMD - 24）和贝克抑郁量表第二版（BDI - II）评估抑郁严重程度。采用疼痛强度数字评定量表（PI - NRS）、简化麦吉尔疼痛问卷中文版第二版（SF - MPQ - 2 - CN）、蒙特利尔认知评估基础版（MoCA - BC）和前瞻性与回顾性记忆问卷（PRMQ）评估研究参与者的疼痛相关特征和整体认知功能。
三组之间PM和RM的损害存在显著差异（F = 7.221，p < 0.001；F = 7.408，p < 0.001），且共病组损害严重。Spearman相关性分析显示，PM和RM分别与持续性疼痛和神经性疼痛呈正相关（r = 0.431，p < 0.001；r = 0.253，p = 0.022和r = 0.415，p < 0.001；r = 0.247，p = 0.025）。回归分析表明情感描述符与BDI - II总分之间存在显著正相关（β = 0.594，t = 6.600，p < 0.001）。对中介途径的检验揭示了PM和RM在MDD和CP共病患者中的间接作用。
与无CP的MDD患者相比，MDD和CP共病患者表现出更多的PM和RM损害。PM和RM可能是影响MDD和CP共病病因的中介因素。
chiCTR2000029917。
