Smedstad L M, Vaglum P, Kvien T K, Moum T
Department of Behavioral Sciences in Medicine, University of Oslo, Norway.
J Rheumatol. 1995 Mar;22(3):514-20.
Self-reported pain is one of the core endpoint measures in RA. The objective of this cross sectional study of 238 patients with rheumatoid arthritis (RA) was to examine the relationship between self-reported pain intensity, sociodemographic variables, anxiety, and depressive symptoms.
A weighted sum score of pain intensity was constructed by combining a visual analog pain scale with items from the Arthritis Impact Measurement Scales (AIMS) and the Nottingham Health Profile. Symptoms of anxiety and depression were measured by subscales of
Multiple regression analyses showed no significant effects of age, sex, income, or level of education on self-reported pain intensity, whereas there was a significant association between the pain index and anxiety and depressive symptoms. The correlation between the pain index and anxiety, and the pain index and depression, was 0.46 for both. Controlling for sociodemographic variables, the Ritchie index, erythrocyte sedimentation rate, and C-reactive protein, the standardized regression coefficients were 0.33 and 0.31 of the pain index on the AIMS anxiety and depression subscale, respectively. Furthermore, the results indicate that the effect of inflammation on mental distress is mediated by pain.
Self-reported pain in RA is not significantly influenced by sex, age, level of education, or income. Even when controlling for disease activity, there was a considerable correlation between self-reported pain and mental distress. Furthermore, our study lends support to the hypothesis that mental distress is mainly secondary to pain rather than vice versa.
自我报告的疼痛是类风湿关节炎（RA）的核心终点指标之一。这项对238例类风湿关节炎患者的横断面研究的目的是检验自我报告的疼痛强度、社会人口统计学变量、焦虑和抑郁症状之间的关系。
通过将视觉模拟疼痛量表与关节炎影响测量量表（AIMS）和诺丁汉健康概况中的项目相结合，构建疼痛强度的加权总分。焦虑和抑郁症状通过……的子量表进行测量。
多元回归分析显示，年龄、性别、收入或教育水平对自我报告的疼痛强度没有显著影响，而疼痛指数与焦虑和抑郁症状之间存在显著关联。疼痛指数与焦虑以及疼痛指数与抑郁之间的相关性均为0.46。在控制社会人口统计学变量、里奇指数、红细胞沉降率和C反应蛋白后，疼痛指数在AIMS焦虑和抑郁子量表上的标准化回归系数分别为0.33和0.31。此外，结果表明炎症对心理困扰的影响是由疼痛介导的。
RA患者自我报告的疼痛不受性别、年龄、教育水平或收入的显著影响。即使在控制疾病活动后，自我报告的疼痛与心理困扰之间仍存在相当大的相关性。此外，我们的研究支持了心理困扰主要继发于疼痛而非相反的假设。
