Objective: Ever since the important role serotonin plays in the mechanism of pain emergence became known, there has been a heightened interest in examining the pain that accompanies psychiatric disorders. However, the relationship between pain and psychiatric disorders remains unclear. In this study, we aimed to obtain information about the frequency and characteristics of pain seen in patients diagnosed with major depressive disorder (MDD) and anxiety disorder (AD).
Method: The Hamilton Rating Scale for Depression (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), and the “Brief Pain Inventory” (BPI) were administered to 94 patients diagnosed with MDD and 94 patients diagnosed with AD, respectively. Comparisons between the diagnosed groups, pain characteristics and socio-demographic variables were examined using the Chi-square and Mann-Whitney U tests in the statistical software package SPSS 11.0. Spearman’s rho test was utilized in order to examine correlation.
Results: Pain complaints in the MDD group were found in 55.3% (n=52), while this figure was 52.1% (n=49) in the AD group. There was no difference in the frequency of experiencing pain between the two groups (p>0.05). Variations of age, gender, and employment status did not correlate to differences in the presence of pain in MDD (p>0.05). In the AD group however, while there were no differences in age and gender regarding the presence of pain, complaints were more frequent in patients who did not work (p<0.05). In both groups, with a longer period of education the patients had received, there was a decrease in pain frequency (p<0.05). There was a positive correlation between HAM-D and HAM-A scores and pain intensity (HAM-D rho=0.217, HAM-A rho=-0.088, p<0.05); however, no correlation was found with the number of pain locations (HAM-D rho=0.165, HAM-A rho=0.105, p>0.05). It was found that pain affected self-care negatively in MDD (p<0.05).
Conclusion: The frequency of pain experienced in MDD and AD patients whom we assessed with the pain survey form was quite high. Additionally, an important finding was that while there was an increase in the intensity of pain with HAM-D , there was no increase in pain locations. It is important that pain is examined and evaluated as a symptom that can emerge in psychiatric disorders and not just a symptom in relation to physical illness.
Amaç: Serotoninin ağrının ortaya çıkış mekanizmasında önemli etkisi olduğu bilindiğinden bu yana psikiyatrik bozukluklara eşlik eden ağrıya olan ilgi artmıştır. Fakat ağrı ile psikiyatrik bozuklukların ilişkisi henüz net olarak bilinmemektedir. Çalışmamızda majör depresif bozukluk (MDB) ve anksiyete bozukluğu (AB) tanısı olanlarda ağrı sıklığı ve özellikleri konusunda bilgi edinmeyi amaçladık.
Yöntem: Doksan dört MDB 94 AB tanılı hastaya, Hamilton Depresyon Değerlendirme Ölçeği (HAM-D), Hamilton Anksiyete Değerlendirme Ölçeği (HAM-A) ve “Kısa Ağrı Envanteri” uygulandı. Tanı grupları, ağrı özellikleri ve sosyodemografik değişkenler arasındaki karşılaştırmalar SPSS 11.0 istatistik paket programında ki-kare ve Mann-Whitney U testi ile incelendi. Korelasyon için Spearman’s rho testi uygulandı.
Bulgular: MDB grubunda ağrı yakınmasının sıklığı %55.3 (n=52), AB grubunda ise %52.1 (n=49) olarak bulundu. Her iki grup arasında ağrı görülme sıklığı açısından fark bulunmadı (p>0.05). MDB’de ağrı varlığında yaş, cinsiyet, çalışma durumu ile ilgili değişkenler farklılık göstermedi (p>0.05). AB’de ağrı varlığında yaş ve cinsiyet karşılaştırmalarında fark saptanmadı fakat çalışmayanlarda ağrı daha fazla gözlendi (p<0.05). Her iki grupta da eğitim süresi arttıkça ağrı görülme sıklığında azalma vardı (p<0.05). HAM-D ve HAM-A puanları ve ağrı şiddeti arasında pozitif korelasyon mevcuttu (HAM-D rho=0.217, HAM-A rho=-0.088, p<0.05) fakat ağrılı bölge sayısı ile bir ilişki görülmedi (HAM-D rho=0.165, HAM-A rho=0.105, p>0.05). Ağrının MDB’de özbakımı daha olumsuz etkilediği gözlendi (p<0.05).
Sonuç: Ağrı anket formu ile değerlendirdiğimiz MDB ve AB hastalarında ağrı görülme sıklığı oldukça yüksekti. Ayrıca HAM-D ile ağrı şiddetinin artması fakat ağrılı bölge sayısının artmaması önemli bir bulguydu. Ağrının sadece fiziksel hastalıklara bağlı değil, psikiyatrik bozukluklarda da ortaya çıkabilecek bir belirti olarak ele alınıp değerlendirilmesi önemlidir.
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