期刊
JOURNAL OF PSYCHOSOMATIC RESEARCH
卷 69, 期 5, 页码 449-457出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jpsychores.2010.05.012
关键词
Chronic pain; Depression; Anxiety; Sleep; Health care utilization
类别
资金
- National Institute of Mental Health [R01 MH070884]
- John D. and Catherine T. MacArthur Foundation
- Pfizer Foundation
- US Public Health Service [R13-MH066849, R01-MH069864, R01 DA016558]
- Fogarty International Center (FIRCA) [R03-TW006481]
- Pan American Health Organization/World Health Organization
- Eli Lilly and Co.
- Ortho-McNeil Pharmaceutical, Inc.
- Bristol-Myers Squibb
- GlaxoSmithKline
- Ministry of Health
Objective: Chronic pain is associated with health problems including sleep difficulties and increased medical utilization. Because chronic pain is frequently comorbid with psychiatric disorders, it is unclear to what degree chronic pain itself is associated with these problems. In a large population sample, we examined the relationship between chronic pain, both alone and comorbid with psychiatric disorders, with sleep disturbance and increased medical utilization. Methods: We analyzed data from the Israel National Health Survey (INHS) conducted in 2003-2004 on a representative sample (N=4859) of the adult Israeli population. Data were collected in face-to-face interviews using the Composite International Diagnostic Interview. Statistical analyses were performed using multinomial logistic regression models. Results: Past year chronic pain was reported by 29.9'% of all study participants (n=1453). Psychiatric disorders were more common among participants with chronic pain; adjusted odds ratios were 2.23 (95% CI 1.49-3.36) for depressive disorders and 2.94 (95% CI 2.08-4.17) for anxiety disorders. Associations of chronic pain and psychiatric disorders were stronger in men. Chronic pain was associated with both sleep problems and increased health care utilization even for individuals with no psychiatric comorbidity. Sleep difficulties but not health care utilization rates were more pronounced in the comorbid group compared to the chronic pain only group. Conclusion: Chronic pain was associated with sleep problems and increased health care utilization in this sample, independent of psychiatric comorbidity. Sleep problems were significantly greater in the comorbid vs. non-comorbid group. In contrast, associations of pain with health care utilization were largely independent of psychiatric comorbidity. (C) 2010 Elsevier Inc. All rights reserved.
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