从急性到慢性背痛转变的生物心理社会风险因素：一项前瞻性队列研究。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2026-03-01 Epub Date: 2025-12-13 DOI:10.1016/j.jpsychores.2025.112500

Petra Engelmann, Mareike Busmann, Bernd Löwe, Paul Hüsing

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引用次数: 0

摘要

背景：生物心理社会机制被认为是背痛慢性化的基础；然而，潜在的相关因素主要是孤立的，而不是综合的病因学模型。本研究基于当前持续躯体症状的生物心理社会模型调查了慢性背痛的危险因素。方法：在前瞻性队列研究IDRIS（“从生物心理社会风险因素的识别到疼痛相关自我效能的增加——慢性背痛的在线解释模型”）中，患有（亚）急性背痛（< 12周）的德国成年人在基线、1个月和3个月的随访中完成了生物心理社会变量的在线问卷调查。在线性回归模型中检验3个月时慢性背痛的可能易感因素和维持因素。研究结果：在2022年12月至2024年7月期间，来自普通人群的280例（亚）急性背痛患者(平均年龄37.52岁（SD 12.41岁）；（65%为女性）完成了所有评估。3个月时慢性背痛的预测因子是1个月随访时的功能失调症状预期（ß = 0.25, p）。解释：本研究支持疼痛相关的消极信念在从急性到慢性背痛转变中的作用，并建议在二级预防干预中解决功能失调症状预期，以减轻疼痛慢性化的风险。未来的研究应该在更长的时间框架内评估临床人群中慢性背痛的假定诱发因素，以评估其长期预测价值。资助：Stiftung Psychosomatik der Wirbelsäulenerkrankungen

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Biopsychosocial risk factors for the transition from acute to chronic back pain: A prospective cohort study

Background

Biopsychosocial mechanisms are assumed to underlie the chronification of back pain; however, potentially relevant factors have mainly been examined in isolation rather than within comprehensive aetiological models. This study investigated risk factors of chronic back pain based on a current biopsychosocial model for persistent somatic symptoms.

Methods

Within the prospective cohort study IDRIS (“From the identification of biopsychosocial risk factors to an increase in pain-related self-efficacy – The online-based conveyance of an explanatory model for chronic back pain”), German adults with (sub)acute back pain (< 12 weeks) completed online questionnaires on biopsychosocial variables at baseline, 1-month and 3-month follow-up. Possible predisposing and maintaining predictors of chronic back pain at 3 months were tested in linear regression models.

Findings

Between December 2022 and July 2024, 280 individuals from the general population with (sub)acute back pain (mean age 37.52 (SD 12.41) years; 65 % female) completed all assessments. Predictors of chronic back pain at 3 months were dysfunctional symptom expectations at 1-month follow-up (ß = 0.25, p < 0.001) and high baseline pain severity grades (highest grade: ß = 0.18, p < 0.01). Other postulated variables did not predict pain chronification.

Interpretation

This study supports the role of negative pain-related beliefs in the transition from acute to chronic back pain and suggests addressing dysfunctional symptom expectations in secondary prevention interventions to mitigate the risk of pain chronification. Future research should assess postulated predisposing factors for chronic back pain in clinical populations over longer timeframes to evaluate their long-term predictive value.

Funding

Stiftung Psychosomatik der Wirbelsäulenerkrankungen.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.