De La Rosa Jennifer S, Brady Benjamin R, Herder Katherine E, Wallace Jessica S, Ibrahim Mohab M, Allen Alicia M, Meyerson Beth E, Suhr Kyle A, Vanderah Todd W
Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States.
Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States.
Pain. 2024 Dec 1;165(12):2877-2887. doi: 10.1097/j.pain.0000000000003340. Epub 2024 Jul 30.
Previous research suggests that individuals with mental health needs and chronic pain may be less likely to use mental health treatment compared with those with mental health needs only. Yet, few studies have investigated the existence of population-level differences in mental health treatment use. We analyzed data from the National Health Interview Survey (n = 31,997) to address this question. We found that chronic pain was associated with end-to-end disparities in the mental health journeys of U.S. adults: (1) Those living with chronic pain are overrepresented among U.S. adults with mental health needs; (2) among U.S. adults with mental health needs, those living with chronic pain had a lower prevalence of mental health treatment use; (3) among U.S. adults who used mental health treatment, those living with chronic pain had a higher prevalence of screening positive for unremitted anxiety or depression; (4) among U.S. adults living with both chronic pain and mental health needs, suboptimal mental health experiences were more common than otherwise-just 44.4% of those living with mental health needs and co-occurring chronic pain reported use of mental health treatment and screened negative for unremitted anxiety and depression, compared with 71.5% among those with mental health needs only. Overall, our results suggest that U.S. adults with chronic pain constitute an underrecognized majority of those living with unremitted anxiety/depression symptoms and that the U.S. healthcare system is not yet adequately equipped to educate, screen, navigate to care, and successfully address their unmet mental health needs.
先前的研究表明，与仅患有心理健康问题的人相比，有心理健康需求且患有慢性疼痛的个体可能不太可能使用心理健康治疗。然而，很少有研究调查在心理健康治疗使用方面人群层面差异的存在情况。我们分析了来自美国国家健康访谈调查（n = 31,997）的数据来解决这个问题。我们发现慢性疼痛与美国成年人心理健康历程中的端到端差异相关：（1）患有慢性疼痛的人在美国有心理健康需求的成年人中占比过高；（2）在美国有心理健康需求的成年人中，患有慢性疼痛的人心理健康治疗使用率较低；（3）在美国使用心理健康治疗的成年人中，患有慢性疼痛的人筛查出未缓解的焦虑或抑郁呈阳性的比例较高；（4）在美国同时患有慢性疼痛和心理健康需求的成年人中，心理健康体验不佳的情况比其他情况更常见——在有心理健康需求且同时患有慢性疼痛的人中，只有44.4%的人报告使用了心理健康治疗且筛查未缓解的焦虑和抑郁呈阴性，而仅患有心理健康需求的人中这一比例为71.5%。总体而言，我们的结果表明，患有慢性疼痛的美国成年人是未缓解焦虑/抑郁症状人群中未得到充分认识的大多数，而且美国医疗保健系统在教育、筛查、引导就医以及成功满足他们未得到满足的心理健康需求方面还没有充分的能力。
