慢性功能性疼痛与心理社会因素的相关性研究

The correlation study of chronic functional pain and psychosocial factors

研究哪些心理社会因素与慢性功能性疼痛（ＣＰ）有关，并探讨ＣＰ的诊断归属。方法采用ＳＣＬ－９０、ＬＥＳ、ＳＳＲＳ、ＤＳＱ、ＨＡＭＤ、ＨＡＭＡ、ＭＭＰＩ等多个量表对５９例ＣＰ患者和３０例器质性疼痛（ＯＰ）患者进行调查，用ｔ检验、χ２检验、多元逐步回归分析等方法对数据进行统计分析。结果ＣＰ组的ＳＣＬ－９０症状评分、负性事件刺激量、不成熟防御方式因子均分、ＨＡＭＤ抑郁分、ＨＡＭＡ焦虑分均明显高于ＯＰ组（Ｐ＜０．０５～０．００１）），社会支持总分显著低于ＯＰ组（Ｐ＜０．００１）。ＭＭＰＩ的廓图表现为１、２、３、７型。结论心理社会因素在ＣＰ的发生、发展中起着重要作用，认为ＣＰ是神经症的一个亚型。

bjective The present study attempts to identify the psychosocial factors associated with chronic functional pain and discuss the diagnosis of CP.Methods A casecontrol study on 59 chronic functional pain patients and 30 organic pain patients was performed.The following seven questionnaires are administered by each subject:Symptom Check List(SCL90),Minnesota Multiphasic Personality Inventory(MMPI),Life Event Scale(LES),Social Support Rating Scale(SSRS),Defense Style Questionnaire(DSQ),Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Rating Scale(HAMA).Results CP patients have higher SCL-90 scores,more negative life events,more immature defense styles and less social support as compared with OP patients(P<0.05～0.001).CP patients express more depression and anxiety than OP patients(P<0.001).CP patients elevate scale 1,2,3 and 7 on the MMPI.Conchusion CP is associated with psychosocial factors and CP is a subtype of neurosis.