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Medically unexplained pain complaints are associated with underlying unrecognized mood disorders in primary care

机译：医学上无法解释的疼痛症状与初级保健中潜在的无法识别的情绪障碍相关

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Background Patients with chronic pain frequently display comorbid depression, but the impact of this concurrence is often underestimated and mistreated. The aim of this study was to determine the prevalence of unrecognized major depression and other mood disorders and comorbid unexplained chronic pain in primary care settings and to explore the associated factors. Also, to compare the use of health services by patients with unexplained chronic pain, both with and without mood disorder comorbidity. Methods A cross-sectional study was carried out in a sample of primary care centers. 3189 patients consulting for "unexplained chronic pain" were assessed by the Visual Analogue Scales (VAS) and the Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaire. Results We report: a) a high prevalence of unrecognized mood disorders in patients suffering from unexplained chronic pain complaints (80.4%: CI 95%: 79.0%; 81.8%); b) a greater susceptibility of women to mood disorders (OR adjusted = 1.48; CI 95%:1.22; 1.81); c) a direct relationship between the prevalence of mood disorders and the duration of pain (OR adjusted = 1.01; CI 95%: 1.01; 1.02) d) a higher comorbidity with depression if the pain etiology was unknown (OR adjusted = 1.74; CI 95%: 1.45; 2.10) and, e) an increased use of health care services in patients with such a comorbidity (p Conclusions The prevalence of undiagnosed mood disorders in patients with unexplained chronic pain in primary care is very high, leading to dissatisfaction with treatment processes and poorer outcomes. Consequently, it seems necessary to explore this condition more regularly in general practice in order to reach accurate diagnoses and to select the appropriate treatment.
机译：背景患有慢性疼痛的患者经常表现出合并抑郁症，但是这种并发的影响常常被低估并且治疗不当。这项研究的目的是确定在初级保健机构中无法识别的严重抑郁症和其他情绪障碍的患病率，以及并发的无法解释的慢性疼痛，并探讨相关因素。此外，比较无法解释的慢性疼痛患者（无论是否患有情绪障碍合并症）对医疗服务的使用。方法对初级保健中心的样本进行横断面研究。通过视觉模拟量表（VAS）和精神障碍初级保健评估（PRIME-MD）问卷评估了3189例“无法解释的慢性疼痛”咨询患者。结果我们报告：a）患有无法解释的慢性疼痛症状的患者中未识别的情绪障碍患病率较高（80.4％：CI 95％：79.0％; 81.8％）; b）妇女对情绪障碍的敏感性更高（OR调整为1.48; CI 95％：1.22; 1.81）; c）情绪障碍的患病率与疼痛持续时间之间存在直接关系（OR调整为1.01; CI为95％：1.01; 1.02）d）如果疼痛病因未知，抑郁症合并症的发生率较高（OR调整为1.74; CI 95％：1.45; 2.10），以及e）在合并症患者中增加使用医疗保健服务（p结论）初级保健中原因不明的慢性疼痛患者中未诊断出的情绪障碍的患病率很高，导致患者对治疗的不满治疗过程和较差的结果，因此，有必要在一般实践中更定期地探索这种情况，以便做出准确的诊断并选择适当的治疗方法。

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