Dworkin Robert H, Richlin David M, Handlin David S, Brand Leonard
Department of Anesthesiology Columbia University College of Physicians and Surgeons, New York, NY, U.S.A. Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, U.S.A. Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY, U.S.A. Department of Anesthesiology, Monmouth Medical Center, Long Branch, NJU.S.A.
Pain. 1986 Mar;24(3):343-353. doi: 10.1016/0304-3959(86)90120-X.
Although it has often been observed that chronic pain and depression are associated, there have been few systematic comparisons of chronic pain patients with and without depression. In the study reported in this article, depressed and non-depressed chronic pain patients were found to be quite similar with respect to demographic, pain-related, and treatment response variables. The primary aim of the study, however, was to examine the hypothesis that treatment response in these two groups of patients would be predicted by different patterns of variables. In non-depressed patients, beneficial response to treatment was related to a greater number of treatment visits, not receiving workmen's compensation, fewer previous types of treatment, and low back pain. As predicted, a different pattern of predictors of treatment response was found for the depressed patients, who were more likely to benefit when they were employed at the beginning of treatment and when their pain was of shorter duration. These results suggest that activity and active involvement in treatment are particularly important with chronic pain patients who are depressed. In addition, they suggest that the best prediction of treatment response in future research on chronic pain patients may be achieved by dividing patients into groups based on psychological characteristics.
尽管人们经常观察到慢性疼痛与抑郁有关，但对伴有和不伴有抑郁的慢性疼痛患者进行的系统比较却很少。在本文所报道的研究中，发现抑郁和非抑郁的慢性疼痛患者在人口统计学、疼痛相关及治疗反应变量方面颇为相似。然而，该研究的主要目的是检验这样一个假设：这两组患者的治疗反应可通过不同的变量模式来预测。在非抑郁患者中，对治疗的有益反应与更多的就诊次数、未领取工伤赔偿、较少的既往治疗类型以及下背部疼痛有关。正如所预测的那样，抑郁患者的治疗反应预测模式不同，他们在治疗开始时就业且疼痛持续时间较短时更有可能受益。这些结果表明，对于抑郁的慢性疼痛患者，活动和积极参与治疗尤为重要。此外，它们还表明，在未来关于慢性疼痛患者的研究中，通过根据心理特征对患者进行分组，可能会实现对治疗反应的最佳预测。
