Abstract：
Musculoskeletal chronic pain is a leading cause of global disability and laboral incapacity. However, there is a lack of population-based studies that investigate the relationship between chronic pain and mental disorders with a control group, particularly among low- and middle-income countries. Chronic pain is a serious public health problem in terms of human suffering, and in terms of socioeconomic implications. Frequent association with different mental disorders increases disability, decreases quality of life, and makes diagnosis and treatment challenging. The present study aimed to evaluate the presence of mental disorders in patients with chronic musculoskeletal pain and compare with a control group without pain.
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.
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.
摘要：
背景：肌肉骨骼慢性疼痛是导致全球残疾和唇功能丧失的主要原因。然而,缺乏以人群为基础的研究，调查慢性疼痛和精神障碍与对照组之间的关系，特别是在低收入和中等收入国家。慢性疼痛是人类痛苦的严重公共卫生问题,以及社会经济影响。经常与不同的精神障碍联系会增加残疾，降低生活质量，并使诊断和治疗具有挑战性。本研究旨在评估慢性肌肉骨骼疼痛患者中精神障碍的存在，并与无疼痛的对照组进行比较。
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。
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。
