Epidemiological Study On Anxiety And Depression Of Patients With Chronic Pain

Chronic pain is a common problem among the crowd,is one of the most common reason of treatment. Because of the complex etiology and pathogenesis of some diseases of unknown,chronic pain has complicated and varied clinical manifestations, the treatment effects are indefintte, even for symptoms similar to patients with the same diagnosis, it is a tough problem for patients and clinicians that using same treatment, while the therapeutic effect were varies widely. At the same time because of chronic pain can increase the emotional disorders, and even cause depression and anxiety . Thus in recent years the psychological factors in the role of chronic pain are thought by more and more. By studying the relationship between psychological factors and etiology of chronic pain and symptoms ,we found that psychological factors is closely related to the occurrence, development and prognosis of chronic pain, therefore, a better understanding of chronic pain patients with psychological conditions of the spirit is particularly important. In China, pain psychology were later compared with developed countries ,and there is great gap between them. We also lack the datas of large sample epidemiological survey of chronic pain.Objective:The purpose of this study is to investigate the prevalence and the relevant factors of psychological problems of patients with chronic pain,and to evaluate the possible occurrence of anxiety and depression risk factors. For the prevention and treatment strategies for chronic pain prove the epidemiological data. Methods:Since October 2007 to July 2008 , we use the self-designed questionnaire to investigate the psychological status of 500 patients with chronic pain, Questionnaire covers the general situation in patients(age,occupation,educational background,Personality characteristics,Economic conditions),Pain(VAS and function in daily life),disease duration,Treatment,symptom-existing timelast three months(the proportion of symptoms at that time a total of three months ),The Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS),visual analogue scale(VAS),the 6-point behavioral rating scale (BRS-6). All data entry EPI data database, Adopted the use of SPSS11.0 packages for statistical analysis. After the assessment of SAS and SDS will be converted into coarse sub-standard score with the test results compared to normal. And to analyze its relationship with gender, age, occupation, educational background, Economic conditions, disease duration, VAS, symptom-existing time, function in daily life, the frequency and the satisfaction of therapeutic effect were evaluated.Results:Recycling of 493 valid questionnaires, has 98.6 percent efficiency, 251 cases of male (50.9%), 242 cases of women (49.1%). The mean±SD of SAS was 49.44±9.27,the mean±SD of male was 47.65±7.94, the mean±SD of female was 51.29±10.17;The mean±SD of SDS was 43.79±10.41, the mean±SD of male was 42.00±8.92,the mean±SD of female was 45.64±11.49. Allwere higher than the national test results of normal mode(SAS 37.23±12.59,SDS 41.88±10.57). If the cut-off points were set at≥50(SAS),and≥53 (SDS),226 patients(45.8%)had symptoms of anxiety and 108 (21.9%) had symptoms of depression., at the same time there were two kinds of symptoms of 98 cases (19.9%). The scores of SAS, SDS were higher than the national normal population, and the incidence of anxiety were correlated with gender, age, income, personality, course of disease, VAS, PPI, symptom-existing time, the impact of the pain of life, treatment frequency, therapeutic effect and depressive disorder. The incidence of depression were correlated with gender, occupation, educational background, character, course of disease, VAS, PPI, symptom-existing time, the impact of the pain of life, treatment frequency, therapeutic effect and anxiety disorders.Conclusions:Psychological problems are common among chronic pain patients and play an important role in the initiation and progression of chronic pain. Chronic pain can not be simply regarded as a physical disease, its occurrence, development and prognosis is closely related to mental factors.In the clinical course of treatment ,psychological therapy has the status that can not be ignored. Researching on mental factors in the etiology of chronic pain, symptomatology and treatment is the urgent tasks of pain Branch, medical psychology, psychiatry and other disciplines.