We selected 100 patients in a regular follow-up at the Musculoskeletal Pain Outpatient Clinic of the University Hospital and compared them with 100 painless individuals from the control group from June 2016 to June 2018. The instruments used were the Mini International Neuropsychiatric Interview (MINI-PLUS) and a structured questionnaire to collect sociodemographic data. Statistical analysis used t-test, chi-square, Fisher\'s exact test, Mann-Whitney, Kolmogorov-Smirnov tests, and multiple logistic regression.
In the sample evaluated, the majority of patients were women (83%), of brown color (54%), with lower-level education (51%), lower salary range (73%) and high absenteeism rate at work (60,7%). Patients with chronic pain had more psychiatric disorders (88% vs. 48% in the control group; p < 0.001). The most frequent diagnoses were anxiety disorders with panic attacks (44%), generalized anxiety (36%), mixed anxiety and depression disorder (33%), social phobia (30%), agoraphobia (29%), suicide risk (28%), and major depression (27%).
Positive correlations of mental disorders and chronic musculoskeletal pain have been documented. This suggests that psychiatric components must be taken into account in the management of chronic pain syndromes. The use of Mini Plus as a diagnostic tool for psychiatric disorders can contribute to optimizing the diagnosis and treatment of patients with chronic pain and encourage the creation of policies with strategies and criteria for quick access to Multi-professional Services.
方法:我们在2016年6月至2018年6月在大学医院肌肉骨骼疼痛门诊进行了定期随访,并将其与对照组的100名无痛个体进行了比较。使用的工具是迷你国际神经精神病学访谈(MINI-PLUS)和收集社会人口统计学数据的结构化问卷。统计学分析采用t检验,卡方,费希尔的精确检验,Mann-Whitney,Kolmogorov-Smirnov测试,和多元逻辑回归。
结果:在评估的样本中,大多数患者是女性(83%),棕色(54%),教育水平较低(51%),较低的工资范围(73%)和高缺勤率(60,7%)。慢性疼痛患者有更多的精神疾病(88%vs.对照组为48%;p<0.001)。最常见的诊断是伴有惊恐发作的焦虑症(44%),广泛性焦虑(36%),混合性焦虑和抑郁障碍(33%),社交恐惧症(30%)广场恐惧症(29%),自杀风险(28%),抑郁症(27%)。
结论:已证明精神障碍与慢性肌肉骨骼疼痛呈正相关。这表明在治疗慢性疼痛综合征时必须考虑精神病成分。使用MiniPlus作为精神疾病的诊断工具有助于优化慢性疼痛患者的诊断和治疗,并鼓励制定具有快速获取多专业服务的策略和标准的政策。