Yang Wenhao, Ma Guangyuan, Li Jingchi, Guan Taiyuan, He Dingchang, Yang Dujiang, Wang Guoyou, Shi Hui
Department of Orthopedics, Luzhou Key Laboratory of Orthopedic Disorders, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, ., Luzhou, Sichuan Province, 646000, PR China.
Southwest Medical University, Luzhou, Sichuan Province, 646000, PR China.
BMC Musculoskelet Disord. 2024 Dec 5;25(1):995. doi: 10.1186/s12891-024-08127-0.
Pain management for knee osteoarthritis (KOA) patients is challenging. Pain arises from both physiological and psychological interactions, with anxiety and depression potentially contributing as risk factors that hinder effective pain management in KOA patients.
Before treatment(T1), A total of 206 elderly inpatients with KOA were enrolled based on initial screening criteria. After treatment (T2), patients were selected based on inclusion and exclusion criteria, and completed follow-up through phone or online questionnaires. The interval between T1 and T2 was three months. Outcome measures included the Visual Analogue Scale (VAS) for pain intensity, Beck Anxiety Inventory (BAI) for anxiety, and Geriatric Depression Scale (GDS) for depression. Descriptive and bivariate analyses were used to evaluate the pain, anxiety and depression of the participants. A cross-lagged model was used to examine the temporal and causal associations among pain, anxiety, and depression.
91% of elderly patients with KOA experienced at least mild depression. Furthermore, 31% of patients reported mild or higher levels of anxiety. At the same time, pain, depression, and anxiety were significantly correlated and mutually predictive(all p < 0.01). Across the different time points, Depression and anxiety at T1 positively predicted pain at T2,with correlation coefficients of 0.19 (p < 0.05) and 0.07 (p < 0.05), respectively.
Anxiety and depression may be potential risk factors limiting the effectiveness of pain management in KOA patients. Clinical treatment should regularly evaluate anxiety and depression levels and integration of psychological interventions or appropriate antianxiety and antidepressant medications.
Not applicable, for the investigative research nature of the study.
膝关节骨关节炎（KOA）患者的疼痛管理具有挑战性。疼痛源于生理和心理相互作用，焦虑和抑郁可能作为危险因素，阻碍KOA患者的有效疼痛管理。
在治疗前（T1），根据初始筛查标准共纳入206例老年KOA住院患者。治疗后（T2），根据纳入和排除标准选择患者，并通过电话或在线问卷完成随访。T1和T2之间的间隔为三个月。结局指标包括疼痛强度视觉模拟量表（VAS）、焦虑贝克焦虑量表（BAI）和抑郁老年抑郁量表（GDS）。采用描述性和双变量分析来评估参与者的疼痛、焦虑和抑郁。采用交叉滞后模型来检验疼痛、焦虑和抑郁之间的时间和因果关联。
91%的老年KOA患者至少经历过轻度抑郁。此外，31%的患者报告有轻度或更高水平的焦虑。同时，疼痛、抑郁和焦虑显著相关且相互预测（所有p<0.01）。在不同时间点上，T1时的抑郁和焦虑正向预测T2时的疼痛，相关系数分别为0.19（p<0.05）和0.07（p<0.05）。
焦虑和抑郁可能是限制KOA患者疼痛管理效果的潜在危险因素。临床治疗应定期评估焦虑和抑郁水平，并整合心理干预或适当的抗焦虑和抗抑郁药物。
不适用，因为该研究具有调查性研究性质。
