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炎症性关节炎患者的疼痛与抑郁和焦虑之间的关系:一个系统性审查
Natasha Cox1, Ashley Hawarden1, Chelsea Kettle2
1Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK; Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership University NHS Foundation Trust, High Lane, Burslem, Staffordshire, UK.
Seminars in arthritis and rheumatism
|September 3, 2025
概括
在炎症性关节炎中,疼痛和抑郁有双向关系. 抑郁症的治疗可以减轻疼痛,这表明生物心理治疗方法可以控制炎症性关节炎的疼痛.
科学领域:
- 关节病学和精神病学
- 系统审查和元分析
- 生物心理社会疼痛模型
背景情况:
- 炎症性关节炎 (IA) 经常伴随抑郁和焦虑.
- 在AI中,疼痛和心理痛苦之间的复杂相互作用需要综合.
- 了解这些协会的指导性和调解者对于有效管理至关重要.
研究的目的:
- 系统地审查IA中疼痛与抑郁/焦虑之间的相关文献.
- 为了确定疼痛与心理痛苦之间的影响方向.
- 确定潜在的调解者和心理治疗对疼痛的影响.
主要方法:
- 到2023年5月进行系统的文献搜索.
- 包括评估类风湿性关节炎/关节炎的疼痛和抑郁/焦虑的研究.
- 对横截面数据的投票计数和元分析;对纵向数据,调解器和治疗效应的叙述综合.
- 使用JBI工具和GRADE进行偏见风险和证据强度评估.
主要成果:
- 包括79项研究; 疼痛和抑郁之间的双向关系被观察到.
- 在单个时间点 (SMD=0. 69) 和纵向发现疼痛与抑郁之间的中等关联.
- 对焦虑的发现不同;焦虑和疼痛之间存在中等关联 (SMD=0.55),但对疼痛和焦虑的关联很小 (SMD=0.03).
- 对调解剂的证据有限;抗抑郁药可以减少伴随抑郁症的疼痛.
- 35%的研究具有高偏差风险;整体证据质量非常低/低.
结论:
- 在炎症性关节炎中存在疼痛和抑郁之间的适度双向关联,尽管证据质量很低.
- 这些发现支持对炎症性关节炎的生物心理治疗策略的应用.
- 需要进一步进行高质量的研究来澄清复杂的关系和治疗影响.
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