Sariyildiz Aylin, Coskun Benlidayi Ilke, Olmez Engizek Sıla, Deniz Volkan
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tarsus University, Mersin, Turkey.
Rheumatol Int. 2023 Dec;43(12):2261-2269. doi: 10.1007/s00296-023-05471-7. Epub 2023 Sep 30.
To evaluate the relation of psychosocial parameters and type D personality with central sensitization in knee osteoarthritis (OA). The study included 126 patients with knee OA according to the American College of Rheumatology criteria. Sociodemographic variables (age, gender, education, marital status, annual income), alcohol consumption/smoking, body mass index, comorbidities, and duration of symptoms were noted. Radiographic evaluation was performed according to the Kellgren-Lawrence grading system. The Western Ontario and McMaster Universities Osteoarthritis Index was used for clinical evaluation. Type D personality, negative affectivity, and social inhibition were evaluated using the type D Scale-14 (DS14). Central sensitization was assessed by the central sensitization inventory (CSI), while psychological status, quality of life, and sleep were assessed by the Hospital Anxiety and Depression Scale (HADS), an abbreviated version of the World Health Organization Quality of Life Instrument (WHOQOL-BREF), and the Jenkins Sleep Evaluation Scale (JSS), respectively. The effect of type D personality on study parameters including central sensitization, as well as the risk factors for the development of central sensitization were assessed by regression analyses. Patients with type D personality had higher CSI, HADS scores and lower WHOQOL-BREF scores for psychological health, social relationship, environment and general quality of life. Linear regression analysis showed that the DS14 total score has a significant positive relation with CSI (β = 0.4, p < 0.05), HADS-depression (β = 0.4, p < 0.05), HADS-anxiety (β = 0.5, p < 0.05), and HADS-total scores (β = 0.5, p < 0.05). It also had a significant negative effect on all domains of WHOQOL-BREF (p < 0.05 for all). Logistic regression analysis revealed that JSS [Odds ratio (OR) 0.83, 95% CI 0.73-0.94; p = 0.003] and negative affectivity (OR 0.78, 95% CI 0.65-0.94; p = 0.008) were independent risk factors for the development of central sensitization in knee OA. Type D personality has an impact on quality of life, central sensitization, and psychological health, with negative affectivity and sleep impairment serving as independent risk factors for central sensitization. While managing patients with knee OA, these intimate relationships should be taken into consideration.
评估心理社会参数和D型人格与膝骨关节炎（OA）中枢敏化之间的关系。根据美国风湿病学会标准，该研究纳入了126例膝OA患者。记录社会人口统计学变量（年龄、性别、教育程度、婚姻状况、年收入）、饮酒/吸烟情况、体重指数、合并症和症状持续时间。根据Kellgren-Lawrence分级系统进行影像学评估。使用西安大略和麦克马斯特大学骨关节炎指数进行临床评估。使用D型量表-14（DS14）评估D型人格、消极情感和社交抑制。通过中枢敏化量表（CSI）评估中枢敏化，同时分别通过医院焦虑抑郁量表（HADS）、世界卫生组织生活质量量表简表（WHOQOL-BREF）和詹金斯睡眠评估量表（JSS）评估心理状态、生活质量和睡眠。通过回归分析评估D型人格对包括中枢敏化在内的研究参数的影响以及中枢敏化发生的危险因素。D型人格患者的CSI、HADS评分更高，而心理健康、社会关系、环境和总体生活质量方面的WHOQOL-BREF评分更低。线性回归分析显示，DS14总分与CSI（β = 0.4，p < 0.05）、HADS抑郁（β = 0.4, p < 0.05）、HADS焦虑（β = 0.5, p < 0.05）和HADS总分（β = 0.5, p < 0.05）呈显著正相关。它对WHOQOL-BREF的所有领域也有显著负面影响（所有p < 0.05）。逻辑回归分析显示，JSS[比值比（OR）0.83，95%可信区间0.73 - 0.94；p = 0.003]和消极情感（OR 0.78，95%可信区间0.65 - 0.94；p = 0.008）是膝OA中枢敏化发生的独立危险因素。D型人格对生活质量、中枢敏化和心理健康有影响，消极情感和睡眠障碍是中枢敏化的独立危险因素。在管理膝OA患者时，应考虑这些密切关系。
