Anxiety and Depression in Youth With Chronic Pain: A Systematic Review and Meta-Analysis.

IF 24.7 1区 医学 Q1 PEDIATRICS
Joanne Dudeney, Rachel V Aaron, Taylor Hathway, Kavya Bhattiprolu, Madelyne A Bisby, Lakeya S McGill, Milena Gandy, Nicole Harte, Blake F Dear
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引用次数: 0

Abstract

Importance: For youth with chronic pain, anxiety and depression are reported as consequences of experiencing pain and maintaining factors of ongoing pain and disability. However, prevalence estimates of anxiety and depression remain unclear.

Objective: To report the prevalence of clinical anxiety and depression for youth with chronic pain and compare symptoms of anxiety and depression between youth with and without chronic pain.

Data sources: MEDLINE, PsycINFO, CENTRAL, and Embase from inception to April 30, 2023.

Study selection: Included studies that reported prevalence data or symptom scores for anxiety and/or depression in individuals younger than 25 years (mean, ≤18 years) with chronic pain and were published in English.

Data extraction and synthesis: From 9648 nonduplicate records, 801 full-text articles were screened. Screening and data extraction occurred in duplicate. Prevalence was determined using event rate calculations. Between-group symptom differences were calculated using Hedges g. Analyses were conducted using the random-effects model. Reporting bias and Grading of Recommendation, Assessment, Development, and Evaluation assessments were conducted.

Main outcomes and measures: Prevalence of anxiety and depression (based on diagnosis and clinical cutoff scores) and differences in anxiety and depression symptoms. Moderators of prevalence and symptom differences were analyzed when data allowed.

Results: A total of 79 studies were included with a total sample of 22 956 youth (n = 12 614 with chronic pain). Most youth were female (mean, 74%), with an age range of 4 to 24 (mean [SD], 13.7 [2.10]) years. The prevalence estimate of anxiety diagnoses was 34.6% (95% CI, 24.0%-47.0%) and the portion that exceeded clinical cutoff scores was 23.9% (95% CI, 18.3%-30.6%). The prevalence of depression diagnoses was 12.2% (95% CI, 7.8%-18.7%) and the portion that exceeded clinical cutoff scores was 23.5% (95% CI, 18.7%-29.2%). Youth with chronic pain had greater symptoms of anxiety (g = 0.61; 95% CI, 0.46-0.77) and depression (g = 0.74; 95% CI, 0.63-0.85) compared with controls. Sex, age, pain location, and recruitment sample may moderate anxiety and depression. Considerable heterogeneity was reported for all outcomes. Studies had a low reporting bias, and outcomes were moderate to high quality.

Conclusions and relevance: The findings of this meta-analysis suggest that 1 in 3 youth with chronic pain meet criteria for anxiety disorder, and 1 in 8 meet criteria for a depressive disorder. This represents a major clinical comorbidity. Moving forward, screening, prevention, and treatment of mental health should be important health care priorities for youth with chronic pain.

青少年慢性疼痛患者的焦虑与抑郁:系统回顾与元分析》(Anxiety and Depression in Youth With Chronic Pain: A Systematic Review and Meta-Analysis.
重要性:据报道,对于患有慢性疼痛的青少年来说,焦虑和抑郁是经历疼痛的后果,也是持续疼痛和残疾的维持因素。然而,焦虑和抑郁的患病率估计仍不明确:报告患有慢性疼痛的青少年临床焦虑症和抑郁症的患病率,并比较患有和不患有慢性疼痛的青少年的焦虑症和抑郁症状:数据来源:MEDLINE、PsycINFO、CENTRAL 和 Embase(从开始到 2023 年 4 月 30 日):纳入的研究报告了25岁以下(平均≤18岁)慢性疼痛患者的患病率数据或焦虑和/或抑郁的症状评分,并以英文发表:从 9648 条非重复记录中筛选出 801 篇全文文章。筛选和数据提取一式两份。患病率通过事件发生率计算确定。使用随机效应模型进行分析。对报告偏差和推荐分级、评估、发展和评价进行了评估:焦虑和抑郁的患病率(基于诊断和临床截断分数)以及焦虑和抑郁症状的差异。在数据允许的情况下,还分析了患病率和症状差异的调节因素:共纳入 79 项研究,样本总数为 22 956 名青少年(n = 12 614 名慢性疼痛患者)。大多数青少年为女性(平均 74%),年龄在 4-24 岁之间(平均 [SD] 13.7 [2.10])。焦虑诊断的流行率估计为 34.6%(95% CI,24.0%-47.0%),超过临床临界分数的部分为 23.9%(95% CI,18.3%-30.6%)。抑郁症诊断率为 12.2%(95% CI,7.8%-18.7%),超过临床临界值的比例为 23.5%(95% CI,18.7%-29.2%)。与对照组相比,患有慢性疼痛的青少年有更严重的焦虑(g = 0.61;95% CI,0.46-0.77)和抑郁(g = 0.74;95% CI,0.63-0.85)症状。性别、年龄、疼痛部位和招募样本可能会减轻焦虑和抑郁。据报道,所有结果都存在相当大的异质性。研究的报告偏倚较低,研究结果的质量为中上等:这项荟萃分析的结果表明,每 3 名患有慢性疼痛的青少年中就有 1 人符合焦虑症的标准,每 8 人中就有 1 人符合抑郁症的标准。这代表了一种主要的临床合并症。今后,心理健康的筛查、预防和治疗应成为慢性疼痛青少年医疗保健的重要优先事项。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JAMA Pediatrics
JAMA Pediatrics PEDIATRICS-
CiteScore
31.60
自引率
1.90%
发文量
357
期刊介绍: JAMA Pediatrics, the oldest continuously published pediatric journal in the US since 1911, is an international peer-reviewed publication and a part of the JAMA Network. Published weekly online and in 12 issues annually, it garners over 8.4 million article views and downloads yearly. All research articles become freely accessible online after 12 months without any author fees, and through the WHO's HINARI program, the online version is accessible to institutions in developing countries. With a focus on advancing the health of infants, children, and adolescents, JAMA Pediatrics serves as a platform for discussing crucial issues and policies in child and adolescent health care. Leveraging the latest technology, it ensures timely access to information for its readers worldwide.
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