Memory Clinical and Research Center of Saint Etienne (CMRR) Neurology Unit, University Hospital of Saint Etienne, Saint Etienne, France.
INSERM, U1219, ACTIVE Team, Bordeaux Population Health Center, University of Bordeaux, Bordeaux, France.
Eur Psychiatry. 2024 Oct 8;67(1):e67. doi: 10.1192/j.eurpsy.2024.1753.
Adverse childhood events (ACEs) have been linked to widespread chronic pain (CP) in various cross-sectional studies, mainly in clinical populations. However, the independent role of different ACEs on the development of different types of CP remains elusive. Accordingly, we aimed to prospectively assess the associations between specific types of ACEs with the development of multisite CP in a large population-based cohort.
Data stemmed from the three first follow-up evaluations of CoLaus|PsyCoLaus, a prospective population-based cohort study of initially 6734 participants (age range: 35-75 years). The present sample included 1537 participants with 2161 analyzable intervals (49.7% men, mean age 57.3 years). Diagnostic criteria for ACEs were elicited using semi-structured interviews and CP was assessed by self-rating questionnaires. Multinomial logistic regressions with generalized estimating equations method analyzed the relationship between the different ACEs measured in the beginning of the interval and the risk of developing multisite CP during the follow-up. Sensitivity analyses were performed to assess the predictive value of ACEs on multisite CP with neuropathic features.
Participants with a history of parental divorce or separation had an increased risk of developing multisite CP at during follow-up in comparison to those without (RR1.98; 95% CI 1.13-3.47). A strong association was highlighted between parental divorce or separation and the risk of subsequent CP with neuropathic characteristics (RR 4.21, 95% CI 1.45-12.18).
These results highlight the importance of psychotherapeutic management of people experiencing parental separation to prevent CP in the future.
在各种横断面研究中，不良的童年经历（ACEs）与广泛的慢性疼痛（CP）有关，这些研究主要集中在临床人群中。然而，不同 ACEs 对不同类型 CP 的发展的独立作用仍不清楚。因此，我们旨在前瞻性评估特定类型 ACEs 与大型基于人群的队列中多部位 CP 发展之间的关联。
数据来自 CoLaus|PsyCoLaus 的前三次随访评估，这是一项最初有 6734 名参与者（年龄范围：35-75 岁）的前瞻性基于人群的队列研究。本样本包括 1537 名参与者，有 2161 个可分析的间隔（49.7%为男性，平均年龄 57.3 岁）。使用半结构式访谈获得 ACE 的诊断标准，并通过自我报告问卷评估 CP。使用广义估计方程方法的多变量逻辑回归分析了在间隔开始时测量的不同 ACE 与随访期间多部位 CP 发病风险之间的关系。进行敏感性分析以评估 ACEs 对多部位 CP 伴神经病变特征的预测价值。
与没有经历过父母离婚或分居的参与者相比，有过父母离婚或分居经历的参与者在随访期间发生多部位 CP 的风险增加（RR1.98；95%CI 1.13-3.47）。父母离婚或分居与随后出现伴有神经病变特征的 CP 的风险之间存在很强的关联（RR 4.21，95%CI 1.45-12.18）。
这些结果强调了对经历父母分离的人进行心理治疗管理以预防未来 CP 的重要性。
