Subclinical psychosis and pain in an English national sample: The role of common mental disorders
Por:
Koyanagi A, Stickley A and Haro JM
Publicada:
1 ago 2016
Ahead of Print:
5 may 2016
Resumen:
Background: Information on the association between subclinical psychosis
and pain is scarce, and the role of common mental disorders (CMDs) in
this association is largely unknown. The aim of the current study was to
therefore assess this association in the general population using
nationally representative data from England.
Methods: Data for 7403 adults aged >= 16 years were used from the 2007
Adult Psychiatric Morbidity Survey. Five forms of psychotic symptoms
were assessed by the Psychosis Screening Questionnaire, while pain was
assessed in terms of the level of its interference with work activity in
the past four weeks. The Clinical Interview Schedule Revised (CIS-R) was
used to assess anxiety disorders, depressive episode, and mixed
anxiety-depressive disorder (MADD). Participants with probable or
definite psychosis were excluded. The association between psychotic
symptoms and pain was assessed by ordinal and binary logistic regression
analysis.
Results: When adjusted for confounders other than CMDs, psychotic
symptoms were significantly associated with pain [e.g., the OR (95%
CI) for the severest form of pain (binary outcome) was 1.78
(1.11-2.85)]. However, this association was no longer significant when
CMDs were controlled for in most analyses. Anxiety disorders and
depressive episode explained 34.8%-47.1% of the association between
psychotic symptoms and pain, while this percentage increased to
62.7%-78.0% when the sub-threshold condition of MADD was also taken
into account.
Conclusions: When coexisting psychotic symptoms and pain are detected,
assessing for anxiety and depression (even at sub-threshold levels) may
be important for determining treatment options. (C) 2016 Elsevier B.V.
All rights reserved.
Filiaciones:
Koyanagi A:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain.
Stickley A:
The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden.
Haro JM:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain
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