Department of Psychology, University of Calgary, Calgary, AB, Canada.
Alberta Children's Hospital Research Institute, Behaviour and the Developing Brain Theme Calgary, AB, Canada.
Pain. 2023 Aug 1;164(8):1810-1819. doi: 10.1097/j.pain.0000000000002879. Epub 2023 Mar 22.
Chronic pain and mental health problems have both been identified as public health emergencies and co-occur at high rates. This prospective, longitudinal investigation examined whether chronic pain status, pain-related symptoms (intensity, interference), pain catastrophizing, and insomnia severity predicted first lifetime onset of depressive and/or anxiety disorders as well as suicidality in a cohort of youth with a parental history of mood and/or anxiety disorders. Participants included 145 youth ( Mage = 13.74 years; 64% female) who completed structured diagnostic interviews at baseline and at 9- and 18-month follow-up to assess depressive and anxiety disorders as well as suicidality. Participants completed baseline questionnaires assessing depressive and anxiety symptoms, pain symptoms and characteristics, pain interference, pain catastrophizing, and insomnia severity. Approximately 25% of youth reported having chronic pain at baseline. Nearly half (47.3%) developed a depressive disorder (21.3%), anxiety disorder (15.7%), or both (10.3%), and 34% endorsed experiencing suicidality at follow-up. Increased pain interference, intensity, catastrophizing, and insomnia severity predicted increased likelihood of first lifetime onset of a depressive disorder at follow-up, over and above sex and baseline symptoms. Chronic pain at baseline was associated with the increased likelihood of onset of suicidality at follow-up. Increased pain intensity and interference at baseline predicted increased severity of suicidality at follow-up. Insomnia severity predicted increased likelihood of anxiety disorder onset. The presence of chronic pain and elevated pain-related symptoms and insomnia are premorbid risk factors for the development of significant mental health disorders and issues in youth.
慢性疼痛和心理健康问题均被认定为公共卫生紧急事件，且二者的并发率很高。本前瞻性纵向研究考察了慢性疼痛状况、与疼痛相关的症状（强度、干扰）、疼痛灾难化和失眠严重程度是否可以预测具有心境和/或焦虑障碍家族史的青年队列中首次出现抑郁和/或焦虑障碍以及自杀意念。参与者包括 145 名青少年（Mage = 13.74 岁；64%为女性），他们在基线和 9 个月和 18 个月的随访时完成了结构化诊断访谈，以评估抑郁和焦虑障碍以及自杀意念。参与者在基线时完成了评估抑郁和焦虑症状、疼痛症状和特征、疼痛干扰、疼痛灾难化和失眠严重程度的问卷。大约 25%的青少年在基线时报告患有慢性疼痛。近一半（47.3%）的人在随访时发展为抑郁障碍（21.3%）、焦虑障碍（15.7%）或两者兼有（10.3%），34%的人在随访时表示经历过自杀意念。与基线相比，疼痛干扰增加、疼痛强度增加、灾难化加重和失眠严重程度增加预测了随访时首次出现抑郁障碍的可能性更高。基线时的慢性疼痛与随访时自杀意念的发生可能性增加有关。基线时的疼痛强度和干扰增加预测了随访时自杀意念严重程度的增加。失眠严重程度预测了焦虑障碍发作的可能性。慢性疼痛和疼痛相关症状以及失眠的出现是青少年出现重大心理健康障碍和问题的潜在风险因素。
