心理因素对纤维肌痛患者定量感觉测试测量结果的调节:系统回顾和元回归分析。

IF 2.9 3区 医学 Q2 PSYCHIATRY
Psychosomatic Medicine Pub Date : 2024-11-01 Epub Date: 2024-08-28 DOI:10.1097/PSY.0000000000001343
Adriana Munhoz Carneiro, Kevin Pacheco-Barrios, Maria Fernanda Andrade, Daniela Martinez-Magallanes, Elly Pichardo, Wolnei Caumo, Felipe Fregni
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引用次数: 0

摘要

研究目的考虑到越来越多的证据表明心理变量可能是纤维肌痛综合征(FMS)的诱因,我们的研究旨在通过系统综述和荟萃分析了解心理因素对 FMS 患者定量感觉测试(QST)的影响:方法:我们在 Pubmed/MEDLINE、EMBASE、Web of Science 和 PsycINFO 数据库中对截至 2024 年 1 月的记录进行了系统检索。我们纳入了 20 项研究(n = 1623,其中 16 项为研究性试验,4 项为非研究性试验),研究偏倚风险为低度或中度:从非随机证据中,我们的荟萃分析发现 FMS 患者的焦虑、抑郁和疼痛灾难化与 QST 测量之间存在基线关系。疼痛灾难化程度越高,CPM 的效率越低。焦虑和抑郁程度越高,PT 值越低。随机证据显示,纤维肌痛治疗后 PT 有显著的统计学增长(ES = 0.29,95% CI 0.03 至 0.56)。该效应不受治疗类型的影响。此外,我们还发现,只有治疗前的焦虑水平会对治疗后的 PT 改善产生负面影响:结论:基线焦虑水平较高的 FMS 患者在干预后 PT 值的增幅较小。抑郁因素对焦虑或抑郁的变化均无显著影响。基线焦虑水平应作为 QST 测量的可能混杂因素加以监测。了解FMS患者的心理因素与QST之间的关系对于改善该综合征的管理和治疗至关重要:CRD42023429397。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychological Factors Modulate Quantitative Sensory Testing Measures in Fibromyalgia Patients: A Systematic Review and Meta-Regression Analysis.

Objective: Considering the growing evidence that psychological variables might contribute to fibromyalgia syndrome (FMS), our study aims to understand the impact of psychological factors in quantitative sensory testing (QST) in FMS patients by performing a systematic review with meta-analysis.

Methods: A systematic search was carried out in PubMed/MEDLINE, EMBASE, Web of Science, and PsycINFO databases for records up until January 2024. We included 20 studies ( n = 1623, 16 randomized controlled trials, and 4 nonrandomized controlled trials) with low or moderate risk of bias included.

Results: From nonrandomized evidence, our meta-analysis found a baseline relationship between anxiety, depression, and pain catastrophizing and QST measures in FMS patients. Higher pain catastrophizing levels were associated with less efficient conditioned pain modulation. Higher anxiety and depression were associated with lower pain threshold (PT). Randomized evidence showed a statistically significant increase in PT after fibromyalgia treatments (effect size = 0.29, 95% confidence interval = 0.03-0.56). The effect was not influenced by treatment type. Moreover, we found that only anxiety levels before treatment negatively influenced the PT improvements after treatment.

Conclusion: FMS patients with higher anxiety levels at baseline showed a smaller increase in PT after the intervention. Depression factor was not significant in either changes in anxiety or depression. Baseline anxiety levels should be monitored as possible confounders of QST measurements. Understanding how psychological factors and QST are related in FMS patients is critical for improving the syndrome's management and treatment.Protocol Registration: CRD42023429397.

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来源期刊
Psychosomatic Medicine
Psychosomatic Medicine 医学-精神病学
CiteScore
5.10
自引率
0.00%
发文量
258
审稿时长
4-8 weeks
期刊介绍: Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society. The journal publishes experimental, clinical, and epidemiological studies on the role of psychological and social factors in the biological and behavioral processes relevant to health and disease. Psychosomatic Medicine is an interdisciplinary peer-reviewed journal devoted to high-quality science on biobehavioral mechanisms, brain-behavior interactions relevant to physical and mental disorders, as well as interventions in clinical and public health settings. Psychosomatic Medicine was founded in 1939 and publishes interdisciplinary research articles relevant to medicine, psychiatry, psychology, and other health-related disciplines. The print journal is published nine times a year; most articles are published online ahead of print. Supplementary issues may contain reports of conferences at which original research was presented in areas relevant to the psychosomatic and behavioral medicine.
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