Angarita-Fonseca Adriana, Roy Mathieu, Lacasse Anaïs, Léonard Guillaume, Rainville Pierre, Marin Marie-France, Tufa Iulia, Gentile Erika L, Pagé M Gabrielle
Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda, QC, Canada.
Research Center of the Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Pain Rep. 2024 May 31;9(4):e1165. doi: 10.1097/PR9.0000000000001165. eCollection 2024 Aug.
We explored trajectories of pain intensity and depressive symptoms over the first 24 months of the pandemic in people with low back pain. This longitudinal study was conducted alongside the Quebec Low Back Pain Study. Starting in April 2020 and every 3 months until July 2022, 291 participants completed an online survey. Group-based trajectory modeling was used to identify patterns of pain intensity and depressive symptoms. Onset outbreak characteristics were then put in relation with trajectory groups using multivariate logistic regression. The analysis revealed 5 trajectories of pain intensity and depressive symptoms, respectively. The pain trajectories were stable mild (n = 17, 5.8%); stable moderate (n = 103, 35.4%); stable severe (n = 81, 27.8%); U-shape (n = 24, 8.3%), and inverted U-shape (n = 66, 22.7%). The trajectories of depressive symptoms were stable none (n = 58, 19.9%); stable very mild (n = 61, 21.0%); stable mild (n = 85, 29.2%); stable moderate (n = 59, 21.7%); and severe slightly improving (n = 24, 8.3%). Pre-COVID everyday/nearly everyday pain, average pain intensity, and widespread bodily pain were predictive of pain trajectory groups. Higher pre-COVID depression, acute stress disorder, and lockdown measures-related stress were associated with moderate/severe depressive trajectories. Our findings indicated relative stability of pain and depressive symptoms among participants during the COVID-19 pandemic but also highlighted subgroups of people who experienced temporary deterioration or improvement over the first months of the pandemic that then reverted back to baseline levels. Modifiable risk factors were identified before the onset of the pandemic, which could give preventive measures in targeted populations.
我们探讨了疫情头24个月中腰痛患者的疼痛强度和抑郁症状轨迹。这项纵向研究是与魁北克腰痛研究同时进行的。从2020年4月开始，每3个月进行一次，直至2022年7月，291名参与者完成了一项在线调查。基于组的轨迹模型用于识别疼痛强度和抑郁症状的模式。然后使用多变量逻辑回归将发病爆发特征与轨迹组联系起来。分析分别揭示了疼痛强度和抑郁症状的5种轨迹。疼痛轨迹为稳定轻度（n = 17，5.8%）；稳定中度（n = 103，35.4%）；稳定重度（n = 81，27.8%）；U形（n = 24，8.3%）和倒U形（n = 66，22.7%）。抑郁症状轨迹为稳定无（n = 58，19.9%）；稳定非常轻度（n = 61，21.0%）；稳定轻度（n = 85，29.2%）；稳定中度（n = 59，21.7%）；以及重度略有改善（n = 24，8.3%）。新冠疫情前每天/几乎每天疼痛、平均疼痛强度和全身广泛性疼痛可预测疼痛轨迹组。新冠疫情前较高的抑郁、急性应激障碍以及与封锁措施相关的压力与中度/重度抑郁轨迹相关。我们的研究结果表明，在新冠疫情期间参与者的疼痛和抑郁症状具有相对稳定性，但也突出了在疫情头几个月经历了暂时恶化或改善然后又恢复到基线水平的亚组人群。在疫情开始前确定了可改变的风险因素，这可为目标人群提供预防措施。
