Hawley Donna J, Wolfe Frederick
School of Nursing, Wichita State University, Wichita, KS 67260-041 USA The Arthritis Research Center, St. Francis Research Institute, Wichita, KSUSA University of Kansas School of Medicine, Wichita, KSUSA Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS), Palo Alto, CAUSA.
Pain. 1994 Nov;59(2):227-234. doi: 10.1016/0304-3959(94)90075-2.
The clinical and neurochemical association between depression and season noted in seasonal affective disorder (SAD) has suggested that clinical pain might also be linked to season, perhaps through similar neurochemistry or the known association of depression with pain. We investigated the pain-light season/dark season hypothesis in 2523 rheumatic disease outpatients by examining VAS Pain and VAS Global Severity scores, as well as levels of depression and functional disability. No clinically significant difference in pain severity between season (or individual month) was noted for the consecutive outpatients at their first clinic visit, nor in sub-analyses using paired light and dark season visits. A slight trend toward increased pain severity in lighter months by about 3% compared to darker months was identified. No effect of season was seen on depression scores. In a subset of patients with high depression scores, rheumatoid arthritis and osteoarthritis patients, respectively, reported 16% and 7% greater pain scores in light compared to dark months, but fibromyalgia patients had stable scores. Season does not appear to play an important role in pain and/or depression in rheumatic disorders.
季节性情感障碍(SAD)中所观察到的抑郁与季节之间的临床及神经化学关联表明,临床疼痛可能也与季节有关,或许是通过类似的神经化学机制,或者是已知的抑郁与疼痛之间的关联。我们通过检查视觉模拟评分法(VAS)疼痛评分、VAS整体严重程度评分以及抑郁水平和功能残疾情况,对2523名风湿性疾病门诊患者的疼痛-光照季节/黑暗季节假说进行了研究。在首次门诊就诊的连续患者中,未发现季节(或各个月份)之间在疼痛严重程度上存在临床显著差异,在使用光照季节和黑暗季节配对就诊的亚分析中也未发现差异。确定了在较明亮月份与较黑暗月份相比,疼痛严重程度有轻微增加的趋势,约为3%。未观察到季节对抑郁评分有影响。在抑郁评分较高的患者亚组中,类风湿关节炎患者和骨关节炎患者分别报告称,与黑暗月份相比,在明亮月份疼痛评分分别高出16%和7%,但纤维肌痛患者的评分稳定。季节似乎在风湿性疾病的疼痛和/或抑郁中并不起重要作用。