广泛性焦虑障碍对慢性疼痛评价的影响

The Effect of Generalized Anxiety Disorder on Assessing the Chronic Pain

慢性疼痛是临床常见的反复发作性疾病,其发病过程中常伴有焦虑障碍的产生。广泛性焦虑障碍(Generalized anxiety disorder,GAD)是其中常见的焦虑障碍之一,可能会加重疼痛程度,影响疼痛治疗。GAD与慢性疼痛相互影响,对慢性疼痛的评估可能造成一定影响。但在当前临床实践中,尚未有工具可以系统、客观地测量慢性疼痛合并GAD患者的实际病情,难以评价GAD对慢性疼痛患者在疼痛评估过程中的影响。本文探讨了慢性疼痛与GAD的相互作用,回顾了现有的GAD评价工具及疼痛测量工具中的焦虑障碍测量部分,发现这些工具在疼痛合并GAD患者的疼痛评估中存在不足之处,并提出研究慢性疼痛与GAD的相互作用机制可能是优化临床实践的方法之一,优化现有评价工具或构建基于叙事医学的医患共建平行病历体系,可能是全面评价慢性疼痛与GAD相互作用的可行研究方向之一。

Chronic pain is a common recurring disease,which is often accompanied by anxiety disorders.Generalized anxiety disorder(GAD)is one of the common anxiety disorders,which may increase the degree of pain and affect the treatment of pain.GAD interacts with chronic pain and may have an impact on the evaluation of chronic pain.However,there is no tool to systematically and objectively measure the actual condition of patients with chronic pain combined with GAD in current clinical practice.And it is difficult to evaluate the impact of GAD on the pain assessment.This article explored the interaction between chronic pain and GAD,reviewed the evaluation tools for GAD and anxiety measurement sections in evaluation tools for pain,fined that there were still shortcomings in the evalutating the severity of chronic pain combined with GAD through these tools.Carrying out the research on the interaction mechanism between chronic pain and GAD may contribute to the optimization of clinical practice.Improving the evaluation tools or constructing a Doctor-patient Co-operated Evidence-based Medical Record based on narrative medicine may be a feasible study to comprehensively evaluate the chronic pain and interaction between chronic pain and GAD.