慢性疼痛患者的焦虑、抑郁现状分析  

Anxiety and depressive disorder status of chronic pain patients

作　　者：宋雨晴 宋涛[1] 董道松[1] 万成福[1] Song Yuqing;Song Tao;Dong Daosong;Wan Chengfu(Pain Department,the First Affiliated Hospital of China Medical University,Shenyang 110000,China)

机构地区：[1]中国医科大学附属第一医院疼痛科,沈阳110000

出　　处：《神经疾病与精神卫生》2024年第9期665-670,共6页Journal of Neuroscience and Mental Health

基　　金：辽宁省科学技术计划项目(2019-BS-295)。

摘　　要：目的分析慢性疼痛患者的焦虑、抑郁情况。方法选取2023年1月—2024年1月于中国医科大学附属第一医院疼痛科住院的455例慢性疼痛患者为研究对象。采用视觉模拟量表(VAS)评估患者的疼痛程度,采用广泛性焦虑量表(GAD-7)和患者健康问卷抑郁症状群量表(PHQ-9)评估患者焦虑抑郁情况。比较不同疾病类型患者焦虑、抑郁情况。采用Spearman相关分析患者的年龄、VAS、GAD-7、PHQ-9评分的相关性。结果本研究发放问卷455份,回收有效问卷407份,问卷有效回收率为89.45%。根据ICD-11慢性疼痛分类标准,将患者分为慢性术后及创伤后疼痛(Ⅰ组)38例、慢性继发性骨骼肌肉疼痛(Ⅱ组)127例、慢性继发性内脏痛(Ⅲ组)18例、慢性继发性头痛或颌面痛(Ⅳ组)39例、慢性神经病理性疼痛(Ⅴ组)71例、慢性原发性疼痛(Ⅵ组)89例和慢性癌性疼痛(Ⅶ组)25例。7组患者的性别、PHQ-9评分比较,差异无统计学意义(P>0.05);年龄、VAS评分、GAD-7评分、疼痛持续时间比较,差异有统计学意义(P<0.05)。407例患者中,焦虑患者占60.37%(248/407),分别为轻度焦虑164例,中度焦虑53例,重度焦虑31例;抑郁患者占67.57%(275/407),分别为轻度抑郁132例,中度抑郁89例,中重度抑郁46例,重度抑郁8例。7组患者的GAD-7总分比较,差异有统计学意义(χ^(2)=13.596,P=0.034);PHQ-9总分比较,差异无统计学意义(χ^(2)=5.417,P=0.492)。相关分析结果显示,慢性疼痛患者VAS评分与患者年龄、GAD-7、PHQ-9评分呈正相关(r=0.105、0.210、0.216,P<0.05);GAD-7评分与PHQ-9评分呈正相关(r=0.647,P<0.05)。结论慢性疼痛患者焦虑抑郁发生率较高,患者焦虑严重程度与抑郁严重程度呈正相关。Objective To explore the anxiety and depressive disorder status of patients with chronic pain.Methods From January 2023 to January 2024,455 chronic pain patients admitted to the Pain Department of the First Affiliated Hospital of China Medical University were selected as participants.Visual Analogue Scale(VAS),Generalized Anxiety Disorder-7(GAD-7),and Patient Health Questionnaire-9(PHQ-9)were used to assess patients'pain,anxiety,and depressive disorder,respectively.Spearman correlation was used to analyze the correlation between patients'age,VAS,GAD-7,and PHQ-9 scores.Results A total of 455 questionnaires were distributed,and 407 valid questionnaires were collected,with a valid response rate of 89.45%.According to the International Classification of Diseases 11th Revision(ICD-11)chronic pain classification criteria,patients were divided into 38 cases of chronic postsurgical or post traumatic pain(GroupⅠ),127 cases of chronic secondary musculoskeletal pain(GroupⅡ),18 cases of chronic secondary visceral pain(GroupⅢ),39 cases of chronic secondary headache or orofacial pain(GroupⅣ),71 cases of chronic neuropathic pain(GroupⅤ),89 cases of chronic primary pain(GroupⅥ),and 25 cases of chronic cancer related pain(GroupⅦ).There was no statistically significant difference in gender and PHQ-9 score among 7 groups of patients(P>0.05),but there was a statistically significant difference in age,VAS score,GAD7 score,and duration of pain(P<0.05).Among the 407 patients,anxiety patients accounted for 60.37%(248/407),and depressive disorder patients accounted for 67.57%(275/407).Among the 407 patients,there were 164 cases of mild anxiety,53 cases of moderate anxiety,and 31 cases of severe anxiety,and there were 132 cases of mild depressive disorder,89 cases of moderate depressive disorder,46 cases of moderate to severe depressive disorder,and 8 cases of severe depressive disorder.Among the 7 groups of patients,there was a statistically significant difference in the total score of GAD-7(χ^(2)=13.596,P=0.034),but there

关 键 词：疼痛 焦虑 抑郁 影响因素 

分 类 号：R402[医药卫生—临床医学]