普通人群的疼痛强度和合并抑郁症状：德国健康更新研究（GEDA 2019/2020-EHIS）分析。

IF 3.5 2区医学 Q1 ANESTHESIOLOGY European Journal of Pain Pub Date : 2024-10-23 DOI:10.1002/ejp.4745

Jan Niklas Ahrend, Kathrin Jobski, Carsten Bantel, Falk Hoffmann

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引用次数: 0

摘要

背景：疼痛和抑郁症状经常同时出现，但疼痛强度的影响仍不明确。本研究分析了德国成年普通人群中疼痛强度与抑郁症状之间的关联：数据来自横断面德国健康更新研究（GEDA 2019/2020-EHIS）。最近4周的疼痛强度分为无痛、轻度、中度和重度。抑郁症状采用 8 项患者健康问卷（PHQ-8）进行评估。抑郁症状发生率的分析包括 95% 置信区间 (95% CI)。多变量逻辑回归通过几率比（OR）分析了与抑郁症状相关的因素：在 22 708 名参与者（51.0% 为女性，35.1% 年龄在 45-64 岁之间）中，41.2% 报告无疼痛，32.1% 报告轻度疼痛，15.3% 报告中度疼痛，11.5% 报告重度疼痛。有抑郁症状的人占总人数的 8.3%（女性占 9.1%，男性占 7.5%）。无疼痛、轻度、中度和重度疼痛的参与者中，分别有 2.5%、6.5%、14.4% 和 27.1% 出现抑郁症状。在多变量分析中，疼痛强度越高，出现抑郁症状的风险越高（轻度疼痛 OR 1.8，95% CI 1.3-2.4；中度疼痛 OR 2.8，95% CI 2.0-4.0；重度疼痛 OR 4.0，95% CI 2.8-5.6）。抑郁症状还与体重指数（BMI）低于 18.5 kg m-2 有关（OR 2.4；95% CI 1.4-4.1），但与性别无关（OR 1.1；95% CI 0.9-1.3）：结论：疼痛强度越高，抑郁症状的风险越大。我们建议中度或重度疼痛患者定期进行疼痛评估，并进一步评估抑郁症状：我们的研究发现，在所有类型的疼痛中，疼痛强度越高，抑郁症状越明显。此外，体重不足与抑郁症状总体相关，而体重不足的重度疼痛患者抑郁症状发生率最高。这些发现强调了对疼痛强度较高的患者，尤其是体重不足的患者进行抑郁症状评估的重要性。

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Pain intensity and comorbid depressive symptoms in the general population: An analysis of the German Health Update Study (GEDA 2019/2020-EHIS)

Background

Pain and depressive symptoms often co-occur, but the influence of pain intensity remains unclear. This study analyses the association between pain intensity and depressive symptoms in the general adult German population.

Methods

Data was obtained from the cross-sectional German Health Update Study (GEDA 2019/2020-EHIS). Pain intensity in the last 4 weeks was categorized into no pain, mild, moderate, and severe. Depressive symptoms were assessed using the 8-item Patient Health Questionnaire (PHQ-8). The prevalence of depressive symptoms was analysed including a 95% confidence interval (95% CI). A multivariable logistic regression analysed associated factors with depressive symptoms by odds ratio (OR).

Results

Of 22,708 participants (51.0% women, 35.1% aged 45–64 years), 41.2% reported no pain, 32.1% mild, 15.3% moderate, and 11.5% severe pain. Depressive symptoms were present in 8.3% overall (women 9.1%, men 7.5%). Participants with no pain, mild, moderate, and severe pain reported depressive symptoms in 2.5%, 6.5%, 14.4%, and 27.1%, respectively. In the multivariable analysis, higher pain intensity was associated with a higher risk of depressive symptoms (mild pain OR 1.8, 95% CI 1.3–2.4; moderate pain OR 2.8, 95% CI 2.0–4.0; severe pain OR 4.0, 95% CI 2.8–5.6). Depressive symptoms were further associated with a Body Mass Index (BMI) under 18.5 kg m⁻² (OR 2.4; 95% CI 1.4–4.1), but not with sex (OR 1.1; 95% CI 0.9–1.3).

Conclusions

Higher pain intensity increases the risk of depressive symptoms. We suggest regular assessment of pain and further assessment of depressive symptoms in patients with moderate or severe pain.

Significance Statement

Our study found a clear association between higher pain intensity and depressive symptoms in the general population across all types of pain. Further, being underweight was linked to depressive symptoms overall and the highest prevalence of depressive symptoms was found in underweight persons with severe pain. These findings highlight the importance of assessing depressive symptoms in patients with higher pain intensity, especially in underweight patients.

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.