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慢性抽动障碍成人患者的疼痛应对

Coping with pain among adults with chronic tic disorders.

作者信息

Małek Agnieszka

机构信息

Chair of Clinical Psychology, Development and Education, Faculty of Social Science, Institute of Pedagogical Sciences, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.

出版信息

Front Psychol. 2025 Jul 30;16:1537088. doi: 10.3389/fpsyg.2025.1537088. eCollection 2025.

Abstract

INTRODUCTION

Tic spectrum disorders-Gilles de la Tourette's syndrome (GTS) and Persistent (Chronic) Motor Tic Disorder (CMTD)-are neurodevelopmental conditions characterized by recurrent motor and/or vocal tics persisting for at least 1 year. While tics are the primary symptom, pain related to tics is an important yet often overlooked aspect of these disorders. Pain can result from the repetitive nature of tics, leading to muscle strain, joint stress, or even injury due to the forceful execution of movements. Additionally, pain resulting from rapid and repeated movements or vocalizations can contribute to chronic discomfort, significantly affecting daily functioning and quality of life. Despite its impact, tic-related pain is not always addressed in clinical practice, leaving individuals struggling to find effective management strategies. The aims of this study were to assess tic-related pain, pain coping strategies and beliefs, and to investigate whether individuals experiencing pain seek professional help and how effective they perceive such interventions to be.

METHODS

A total of 76 participants diagnosed with GTS and CMTD participated in the study. The following scales were used: Yale Global Tic Severity Scale (YGTSS), Visual Analog Scale (VAS), Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), Pain Coping Strategies Questionnaire (CSQ), Beliefs Questionnaire for Pain Control (BPCQ), and a survey containing demographic and health data and questions about pain management and its effectiveness.

RESULTS

73.7% of participants reported tic-related pain; almost all of them declared pain located in more than one part of the body. Affective pain domain was the highest scored by both men and women. Coping self-statements was the most common coping strategy chosen by men, whereas catastrophizing was preferred by women. Respondents rated internal factors as the most important in pain management and external factors, particularly medical professionals, as the least important. This aligns with their experience, as fewer than one in five found professional interventions effective in relieving pain.

CONCLUSION

Pain should be recognized as a common comorbid aspect of tic disorders and therefore both pharmacological and non-pharmacological interventions should include pain management. Chronic pain can significantly impair functioning in all areas of life and recommendations for the management of tic-related pain need to be developed.

摘要

引言

抽动谱系障碍——抽动秽语综合征(GTS)和持续性(慢性)运动抽动障碍(CMTD)——是神经发育性疾病,其特征为反复出现的运动和/或发声抽动,持续至少1年。虽然抽动是主要症状,但与抽动相关的疼痛是这些疾病的一个重要但常被忽视的方面。疼痛可能源于抽动的重复性,导致肌肉劳损、关节压力,甚至因强力执行动作而受伤。此外,快速重复的动作或发声所导致的疼痛会造成慢性不适,严重影响日常功能和生活质量。尽管其有影响,但在临床实践中,与抽动相关的疼痛并不总是得到处理,这使得患者难以找到有效的管理策略。本研究的目的是评估与抽动相关的疼痛、疼痛应对策略和信念,并调查经历疼痛的个体是否寻求专业帮助以及他们认为此类干预措施的效果如何。

方法

共有76名被诊断为GTS和CMTD的参与者参加了该研究。使用了以下量表:耶鲁全球抽动严重程度量表(YGTSS)、视觉模拟量表(VAS)、简短麦吉尔疼痛问卷 - 2(SF-MPQ-2)、疼痛应对策略问卷(CSQ)、疼痛控制信念问卷(BPCQ),以及一份包含人口统计学和健康数据以及关于疼痛管理及其效果问题的调查问卷。

结果

73.7%的参与者报告了与抽动相关的疼痛;几乎所有人都宣称疼痛位于身体的多个部位。情感疼痛领域在男性和女性中得分最高。应对自我陈述是男性选择的最常见应对策略,而女性则更倾向于灾难化。受访者将内部因素评为疼痛管理中最重要的因素,而将外部因素,特别是医疗专业人员,评为最不重要的因素。这与他们的经历相符,因为不到五分之一的人认为专业干预对缓解疼痛有效。

结论

疼痛应被视为抽动障碍的常见共病方面,因此药物和非药物干预都应包括疼痛管理。慢性疼痛会显著损害生活各方面的功能,需要制定与抽动相关疼痛的管理建议。

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