Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Germany.
Clin Exp Rheumatol. 2023 Jun;41(6):1301-1309. doi: 10.55563/clinexprheumatol/i7kod6. Epub 2023 Jun 28.
The COVID-19 pandemic, along with the associated restrictions and changes, has had a far-reaching impact on the mental health and well-being of people around the world. The most serious impact can arguably be observed in vulnerable populations, such as chronic pain patients. Using a pre-test/post-test design with pre-pandemic comparative data, the present study sought to investigate how the pandemic impacted chronic pain and well-being in individuals with fibromyalgia (FM) (N = 109).
We assessed longitudinal changes of various clinical parameters, such as pain severity, disability, FM impact, depressive mood and several items assessing the individual experience of the pandemic as well as self-perceived changes of pain, anxiety, depression and physical activity levels.
Results suggested a significant self-perceived worsening of pain, depressive mood, anxiety as well as reduced physical activity due to the pandemic. Interestingly, these self-perceived changes were not reflected in longitudinal increases of test values (T1-T2). Pain severity at T1 was the strongest predictor of pain severity at T2, while COVID-related outcomes showed no critical importance, with COVID-related fear being the only significant predictor of T2 pain. The general perceived negative impact of the pandemic was the only predictor of self-perceived worsening of pain. Finally, patients with less severe pre-pandemic pain symptoms displayed greater longitudinal worsening of pain.
These findings emphasise the importance of addressing the specific needs of chronic pain suffers during a pandemic.
COVID-19 大流行及其相关限制和变化对全球范围内人们的心理健康和幸福感产生了深远影响。最严重的影响可以说是在弱势群体中观察到的,例如慢性疼痛患者。本研究采用预测试/后测试设计和大流行前的比较数据,旨在调查大流行如何影响纤维肌痛 (FM) 患者的慢性疼痛和幸福感(N=109)。
我们评估了各种临床参数的纵向变化,例如疼痛严重程度、残疾、FM 影响、抑郁情绪以及评估个人大流行经历的几个项目以及自我感知的疼痛、焦虑、抑郁和身体活动水平的变化。
结果表明,由于大流行,疼痛、抑郁情绪、焦虑以及身体活动减少的自我感知明显恶化。有趣的是,这些自我感知的变化并没有反映在测试值(T1-T2)的纵向增加中。T1 时的疼痛严重程度是 T2 时疼痛严重程度的最强预测因素,而与 COVID 相关的结果并不重要,与 COVID 相关的恐惧是 T2 疼痛的唯一显著预测因素。大流行的普遍负面感知是自我感知疼痛恶化的唯一预测因素。最后,大流行前疼痛症状较轻的患者疼痛的纵向恶化程度更大。
这些发现强调了在大流行期间满足慢性疼痛患者特定需求的重要性。