Meincke, Line Koldsø

Baggrund: Muskel og skeletlidelser er en af de største grupper af kroniske lidelser i Danmark, hvor 800.000 lever med kroniske smerter. Smerter har vist, at have en negativ indvirkning på livskvaliteten. Ved kroniske smerter er der fundet et samspil mellem biologiske, psykologiske og sociale faktorer, hvor flere studier viser, at patienterne ofte har en psykisk lidelse som fx depression samtidig.Det ønskes derfor, at undersøge om patienter med rygsmerter og samtidig mistanke om en psykisk lidelse, rapporterer om et højere smerteniveau end patienter uden denne mistanke.Metode: Der er tale om en tværsnitsundersøgelse af 656 patienter som i perioden 1. januar 2012 og 31. januar 2013 blev set på reumatologisk afdeling. Alle patienter havde svaret på spørgsmål vedr. smerter. Smerter blev defineret ved numerisk rating skala (NRS), og efterfølgende opdelt i lette smerter (NRS 0-6) samt stærke smerter (NRS 7-10). Patienter blev endvidere vha. spørgeskemaer screenet for psykiske lidelser. Sammenhængen mellem mistanke om psykisk lidelse og smerteniveau blev vurderet ved hjælp af logistisk regressionsmodel.Resultater: 81% havde mistanke om somatisering, helbredsangst (65%), angst (30%) og depression (32%). Havde man en psykisk lidelse, var der større odds for, at have stærke smerter. Kvinder sammenlignet med mænd havde odds ratio (OR) 1.5 og dermed større risiko for stærke smerter. Patienter mellem 41-65 år havde mindst risiko for, at rapportere om stærke smerter (OR 0.75-0.79). Patienter med en høj uddannelse, havde mindre risiko for stærke smerter, sammenlignet med patienter med en grunduddannelse (OR 0.37).Konklusion: Resultaterne viste, at patienter med mistanke om en psykisk lidelse havde en større risiko for stærke smerter, sammenlignet med patienter uden denne mistanke. Kvinder havde størst risiko for stærkere smerter, og personer med en høj uddannelse havde mindre risiko for smerter.Muscle and skeletal disorders represent one of the largest groups of chronic disorders in Denmark with 800.000 people living with chronic pain. This has a negative impact on quality of life. Furthermore, biological, psychological and social factors have been found to directly affect pain behavior. Thus, patients suffering from chronic pain should be more likely to also have mental disorders such as depression.The aim was to examine whether patients with back pain and suspicion of mental disorders, reported higher levels of pain than patients without this suspicion. The study was based on a cross-sectional study of 656 patients who visited the Department of Rheumatology between January 1, 2012 and January 31, 2013. All patients responded to a questionnaire about pain, which was defined by a numerical rating scale (NRS) ranging from 0 to 10 with mild pain ranging 0-6 and severe pain 7-10.Additionally, patients were screened for mental disorders through questionnaires. These were assessed using logistic regression models to estimate associations between suspected mental suffering and reported level of pain.The screenings for mental disorders caused suspicion of somatization (81%), health anxiety (65%), anxiety (30%) and depression (32%). Suspicion of mental disorders increased the odds of reporting severe pain (somatization OR (2.5), health anxiety OR (2.4) anxiety OR (1.6) and depression OR (1.5)). Women compared to men had odds ratio (OR) 1,5 and thus had a greater risk of being in severe pain, while patients with high educations had lower risks of suffering from severe pain, compared to patients with basic educations (OR 0.37).In conclusion, suspicion of mental disorders was associated with an increased reporting of pain in patients who visited the Department of Rheumatology in relation to neck and back pain. Moreover, women and people with basic educations were associated with reporting of more severe pains.<br/

Pain experiences in patients with suspicion of somatization or mental disorder

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