بررسی مقطعی به منظور بررسی شیوع درد در بیماران ژاپنی مبتلا به اختلال افسردگی عمده و اسکیزوفرنی

We conducted a cross-sectional survey to assess the prevalence of physical pain in Japanese major depressive disorder (MDD) and schizophrenia (SZ) patients as well as in healthy controls (HCs). We also examined the association between their psychopathology and characteristics of pain according to a face-to-face survey by an experienced psychiatrist and psychologist. We analyzed 233 HCs, 94 MDD patients, and 75 SZ patients using the McGill Pain Questionnaire (MPQ) and SF-8 (all participants), the Hamilton Depression Rating Scale 21 items (MDD patients), and the Positive and Negative Symptom Scale (SZ patients). Although MDD patients experienced more pain than HCs, there was no difference in the prevalence of pain between SZ patients and HCs. Moreover, HCs with pain did not have higher SF-8 total scores than those without pain, whereas both MDD and SZ patients with pain had higher SF-8 total scores than those without pain. The severity of psychopathology in MDD and SZ patients was also positively associated with both the prevalence of pain and MPQ scores. MPQ scores were also associated with positive symptoms in SZ patients. Considering these results, physicians need to query MDD patients about physical pain during examination if they are to ensure a favorable and quick response to treatment. The severity of positive symptoms (i.e., clinical status) in SZ patients might also be associated with pain sensitivity, and warrants further investigation.

Patients with psychiatric disorders, such as major depressive disorder (MDD) and schizophrenia (SZ), differ in the prevalence and intensity of pain compared with healthy controls (HCs) [1], [2], [3], [4] and [5]. For example, MDD is associated with a higher prevalence of pain than HCs [1], [2] and [3]. A Web-based survey was recently conducted to assess the perception of pain in Japanese patients with depression [4]; the study revealed that 64.0% of patients with depression experience at least one painful symptom. Many patients with depression are aware of having some kind of pain as a result of the study, and only 61.7% physicians ask their patients about pain during a consultation [4]. On the other hand, the number of studies on prevalence of pain in SZ is small. A recent review [5] states that SZ patients have lower prevalence of pain as well as lower intensity of pain than do those with other psychiatric disorders [5]. Pain related to medical conditions (e.g., myocardial infarction) appears to have a lower prevalence in patients with SZ than in HCs [5]. However, such a difference was not observed for pain without an apparent medical reason [5]. However, no studies have evaluated the prevalence of pain in Japanese patients with psychiatric disorders using face-to-face evaluation, and no studies have evaluated an association between the symptom of pain using the McGill Pain Questionnaire (MPQ) [6] and psychopathology of SZ using the Positive and Negative Symptom Scale (PANSS) [7]. Thus, we conducted a cross-sectional survey to assess the prevalence of pain in Japanese MDD and SZ patients as well as in HC. We also examined the association between their psychopathology and characteristics of pain according to a face-to-face survey by an experienced psychiatrist and psychologist.