Sist T C, Florio G A, Miner M F, Lema M J, Zevon M A
Department of Anesthesiology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
J Pain Symptom Manage. 1998 Jun;15(6):350-8. doi: 10.1016/s0885-3924(98)00006-2.
The present study investigated the relationship between depression and pain description among cancer and chronic non-cancer pain patients in a large outpatient sample. Participants consisted of 312 patients (158 men and 154 women) attending a pain management clinic at a comprehensive cancer institute. Sixty-one percent of the patients (190/312) were experiencing pain related to cancer and 39% (122/312) were experiencing chronic nonmalignant pain. Multivariate analyses of covariance were used to assess differences in the sensory and affective indices of the McGill Pain Questionnaire (MPQ) associated with depression and type of pain. Current pain intensity was the covariate. The results indicated that the MPQ affective and sensory intensity scales did not significantly differ among patients with cancer and chronic non-cancer pain. There were also no significant differences in the percentage of affective and sensory pain descriptors chosen by these patients. However, depression significantly influenced MPQ pain description. Depressed patients with pain scored higher on the affective pain intensity dimension of the MPQ than non-depressed patients with pain (P < 0.001). Depressed patients also chose more affective pain descriptors than non-depressed patients (P < 0.001). Chi-square analyses revealed that depressed and non-depressed pain patients made significantly different choices on four of the five MPQ affective adjective lists. There were no differences in the sensory pain index or the percentage of sensory pain descriptors based on depression. These findings are discussed in terms of their clinical implications and their relationship to the existing literature.
本研究在一个大型门诊样本中，调查了癌症患者和慢性非癌症疼痛患者的抑郁与疼痛描述之间的关系。参与者包括312名在一家综合癌症研究所的疼痛管理诊所就诊的患者（158名男性和154名女性）。61%的患者（190/312）患有与癌症相关的疼痛，39%（122/312）患有慢性非恶性疼痛。采用多变量协方差分析来评估与抑郁和疼痛类型相关的麦吉尔疼痛问卷（MPQ）的感觉和情感指标的差异。当前疼痛强度作为协变量。结果表明，MPQ情感强度量表和感觉强度量表在癌症患者和慢性非癌症疼痛患者中没有显著差异。这些患者选择的情感性和感觉性疼痛描述词的百分比也没有显著差异。然而，抑郁显著影响MPQ疼痛描述。疼痛的抑郁患者在MPQ情感疼痛强度维度上的得分高于疼痛的非抑郁患者（P < 0.001）。抑郁患者也比非抑郁患者选择了更多的情感性疼痛描述词（P < 0.001）。卡方分析显示，抑郁和非抑郁的疼痛患者在MPQ五个情感形容词列表中的四个上做出了显著不同的选择。基于抑郁的感觉疼痛指数或感觉疼痛描述词的百分比没有差异。本文根据这些发现的临床意义及其与现有文献的关系进行了讨论。
