Education Programme Partner, Aplysia APS, University of Pisa, Florence, Italy.
GIFT Institute of Integrative Medicine, Pisa, Italy.
Psychiatr Q. 2023 Jun;94(2):297-310. doi: 10.1007/s11126-023-10026-x. Epub 2023 Jun 2.
Although previous studies have shown that psychiatric and personality disorders are more prevalent in chronic pain than in pain-free groups, few studies have investigated the prevalence of personality disorders (PerDs) in patients with chronic pain with and without a psychiatric comorbidity. The aim of the present study was therefore designed to investigate the burden of PerDs on the prevalence and perception of chronic pain in patients with and without psychiatric comorbidity. 232 patients from the Gift Institute for Integrative Medicine in Pisa, Italy, of which n = 161 (69.4%) were patients with chronic pain, were administered the SCID II for personality disorders and MINI for DSM IV-TR criteria. Both psychiatric and personality disorders were more prevalent in the chronic pain group than in the pain-free group (χ2 = 5.9, p = .015, φ = .16; χ2 = 7.2, p = .007, φ = .18). Cluster A and C PerDs were more prevalent in patients with chronic pain than in subjects without pain (χ2 = 8.1, p = .004, φ = .19; χ2 = 4.7, p = .030, φ = .14, respectively). Unlike Cluster C PerDs, however, Cluster A PerDs were more prevalent in the absence of psychiatric comorbidity (χ2 = 5.0, p = .024, φ = .29), and by themselves worsened the pain perceived. An appropriate PerD diagnosis can be helpful in the treatment of patients with chronic pain.
尽管先前的研究表明，精神疾病和人格障碍在慢性疼痛患者中比在无痛患者中更为普遍，但很少有研究调查患有和不伴有精神共病的慢性疼痛患者中人格障碍（PerD）的患病率。因此，本研究旨在调查 PerD 对伴有和不伴有精神共病的慢性疼痛患者的患病率和疼痛感知的影响。来自意大利比萨综合医学研究所的 232 名患者接受了 SCID II 人格障碍和 MINI DSM-IV-TR 标准的评估。患有慢性疼痛的患者有 161 名（69.4%），精神病和人格障碍在慢性疼痛组中比在无痛组中更为普遍（χ2=5.9，p=0.015，φ=0.16；χ2=7.2，p=0.007，φ=0.18）。与无疼痛者相比，慢性疼痛患者的 A 型和 C 型 PerD 更为常见（χ2=8.1，p=0.004，φ=0.19；χ2=4.7，p=0.030，φ=0.14）。然而，与 C 型 PerD 不同，A 型 PerD 在没有精神共病的情况下更为常见（χ2=5.0，p=0.024，φ=0.29），而且它本身会加重疼痛感知。适当的 PerD 诊断可以帮助治疗慢性疼痛患者。
