抑郁症共病慢性疼痛患者焦虑情绪与疼痛强度、疼痛敏感性的相关性研究  

Correlation between anxiety,pain intensity,and pain sensitivity in comorbidity of depressive disorder and chronic pain

作　　者：郑梅 高莉玲 高桦 陈苑苑 杨德英 谢雯[1,3] 朱翠珍 Zheng Mei;Gao Liling;Gao Hua;Chen Yuanyuan;Yang Deying;Xie Wen;Zhu Cuizhen(School of Mental Health and Psychological Science,Anhui Medical University,Hefei 230022,China;Psychiatry Department,Anhui Medical University Affiliated Mental Hospital&Hefei Fourth People's Hospital,Hefei 230022,China;Department of Anxiety and Depression,Anhui Medical University Affiliated Mental Hospital&Hefei Fourth People's Hospital,Hefei 230022,China;Department of Science and Education,Anhui Medical University Affiliated Mental Hospital&Hefei Fourth People's Hospital,Hefei 230022,China)

机构地区：[1]安徽医科大学精神卫生与心理科学学院,合肥230022 [2]安徽医科大学附属心理医院合肥市第四人民医院精神科,230022 [3]安徽医科大学附属心理医院合肥市第四人民医院焦虑抑郁科,230022 [4]安徽医科大学附属心理医院合肥市第四人民医院科教科,230022

出　　处：《神经疾病与精神卫生》2024年第3期170-176,共7页Journal of Neuroscience and Mental Health

基　　金：安徽省重点研究与开发计划项目(2022e07020002);合肥市卫生健康应用医学研究项目;合肥市第四人民医院院级项目(HFSY2022ZD12)。

摘　　要：目的分析抑郁症共病慢性疼痛患者的焦虑情绪对疼痛强度和疼痛敏感性的影响。方法采用横断面调查法,选取2021年9月—2023年6月在安徽省精神卫生中心门诊就诊及住院治疗的108例抑郁症患者为研究对象,根据是否共病慢性疼痛将患者分为共病组(52例)和非共病组(56例)。同期在社会公开招募48名健康者纳入对照组。采用贝克焦虑量表(BAI)、贝克抑郁量表(BDI-Ⅱ)调查两组患者焦虑、抑郁症状。采用蒙特利尔认知评估量表(MoCA)、疼痛强度数值评定量表(PI-NRS)和疼痛敏感性问卷(PSQ)调查3组受试者认知功能、疼痛强度及疼痛敏感性。采用多重线性回归分析和受试者工作特征(ROC)曲线分析抑郁症共病慢性疼痛患者的焦虑情绪对疼痛强度和疼痛敏感性的影响。结果两组患者的MoCA总分低于对照组,共病组患者PSQ-total得分、PSQ-minor得分高于对照组,共病组患者BAI总分、躯体性焦虑得分、精神性焦虑得分、BDI-Ⅱ得分、PI-NRS得分高于非共病组,差异均有统计学意义(均P<0.05)。多重线性回归分析显示,抑郁症共病慢性疼痛患者的躯体性焦虑是疼痛强度的影响因素(P<0.01);精神性焦虑是PSQ-minor、PSQ-moderate和PSQ-total的影响因素(P<0.01)。ROC曲线分析显示,BAI总分预测抑郁症共病慢性疼痛患者疼痛程度和敏感性的ROC曲线下面积为0.916,最佳临界值为0.416,敏感度为0.885,特异度为0.875。结论抑郁症共病慢性疼痛患者的焦虑情绪与疼痛强度和疼痛敏感性呈正相关,焦虑情绪的严重程度是抑郁症共病慢性疼痛患者疼痛强度和疼痛敏感性的影响因素。Objective To explore the influence of anxiety on pain intensity and sensitivity in comorbidity of depressive disorder and chronic pain.Methods This study was a cross-sectional survey.From September 2021 to June 2023,108 patients with depressive disorder who received outpatient and inpatient treatment at the Anhui Mental Health Center were selected as the research subject.Patients were divided into a comorbid group(52 cases)and a non-comorbid group(56 cases)based on whether there was comorbid chronic pain.During the same period,48 healthy individuals were recruited from the public to be included in the control group.Beck Anxiety Inventory(BAI)and Beck Depression Inventory(BDI-Ⅱ)were used to investigate anxiety and depression symptoms in two groups of patients.Montreal Cognitive Assessment(MoCA),Pain Intensity Numerical Rating Scale(PI-NRS),and Pain Sensitivity Questionnaire(PSQ)were used to investigate cognitive function,pain severity,and pain sensitivity among three groups of participants.Multiple linear regression analysis and receiver operating characteristic(ROC)curve were used to analyze the impact of anxiety on pain intensity and sensitivity in comorbidity of depression and chronic pain.Results The total MoCA scores of the two groups of patients were lower than those of the control group,the PSQ-total scores and PSQ-minor scores of the comorbid group were higher than those of the control group,and the total BAI scores,physical anxiety scores,psychological anxiety scores,BDI-Ⅱscores,and PI-NRS scores of the comorbid group were higher than those of the non-comorbid group,and the differences were statistically significant(all P<0.05).Multiple linear regression analysis showed that physical anxiety was a factor influencing pain intensity in comorbidity of depressive disorder and chronic pain,and psychological anxiety was a factor influencing PSQ-minor,PSQ-moderate,and PSQ-total,and the differences were statistically significant(all P<0.01).ROC curve analysis showed that the area under the ROC curve for predi

关 键 词：抑郁症 慢性疼痛 焦虑 疼痛强度 疼痛敏感性 

分 类 号：R749.4[医药卫生—神经病学与精神病学]