COMORBIDITY OF PHYSICAL AND MENTAL HEALTH CONDITIONS

身体和心理健康状况的共病

• 批准号: 2240522
• 负责人: ROBERT Joseph GATCHEL
• 金额: $ 9.68万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-08-01 至 1998-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2240522
• 关键词: backache; cognitive behavior therapy; health surveys; human subject; interview; longitudinal human study; occupational therapy; pain; person with disability; personality disorders; physical therapy; psychotherapy; stress; temporomandibular joint

The proposal presents three separate research projects that will explore the nature of the relationship or comorbidity of psychopathology and physical disability, specifically temporomandibular disorder and low back pain disability. The major goal of the first project is to evaluate whether DSM-III-R Axis I and II diagnoses will serve as useful predictors for those acute low back pain patients who subsequently develop chronic disability problems. A conceptual model of the transition from acute to chronic pain is proposed which guides this research. This study will provide the first important statistics on the incidence of specific psychiatric and personality disorders within an exclusively acute low back pain population that may be linked with subsequent chronicity. The second project will focus on evaluating the active components of a functional restoration treatment program for chronic low back pain disability. For these chronic pain patients, significant psychopathology is often evidenced. Functional restoration has been found to be quite effective at getting these chronically disabled patients back to work. An important question still remaining is what components (both psychological and physical) are most important for treatment success. Addressing this issue may allow the development of a more time- and cost- efficient treatment program. Finally, the third proposed project will be similar to the first project, but it will target a different clinical population--patients with temporomandibular disorder (TMD). It will help test how generalizable the proposed conceptual model is of the transition from acute to chronic pain. It should be noted that chronic TMD and chronic low back pain are disabilities that have many things in common. This is why research in both areas is being simultaneously pursued. For example, there is often great difficulty unequivocally diagnosing organic underpinnings of both of these disorders. Moreover, psychological factors have been implicated to play a very important role in the etiology and maintenance of these syndromes. There have also been many psychological and physical approaches advocated for treating these disorders, although the majority have not been empirically demonstrated to be successful. In addition, there has been an increase in the apparent prevalence and perceived severity of these disorders over the past decade, making them both costly societal and economic problems. Finally, involvement in this work with TMD and chronic low back pain reveals a close relationship or comorbidity of psychopathology and these physical disabilities. These three research projects will further explore the nature of this comorbidity.

该提案提出了三个单独的研究项目，这些项目将探索 心理病理学的关系或合并症的性质和合并症 身体残疾，特别是颞下颌疾病和下背部 疼痛障碍。 第一个项目的主要目标是评估 DSM-III-R轴I和II诊断是否会作为有用的预测指标 对于那些随后发展慢性的急性下腰痛患者 残疾问题。 从急性到过渡的概念模型 提出了指导这项研究的慢性疼痛。 这项研究会 提供有关特定发病率的第一个重要统计数据 精神病和人格障碍仅在急性低位 背痛种群可能与随后的慢性有关。 这 第二个项目将着重于评估A的主动组件 慢性腰痛的功能恢复治疗计划 残疾。 对于这些慢性疼痛患者，大量的心理病理学 经常证明。 发现功能恢复已经很 有效地使这些长期残疾的患者重返工作岗位。 仍然剩下的一个重要问题是哪些组成部分（两者都 心理和身体）对于治疗成功是最重要的。 解决此问题可能会允许开发更多的时间和成本 - 有效的治疗计划。 最后，第三个提议的项目将 与第一个项目相似，但它将针对不同的临床 人口 - 患者患有颞下颌疾病（TMD）。 它将有所帮助 测试拟议的概念模型的推广方式 从急性到慢性疼痛。 应该注意的是，慢性TMD和 慢性腰痛是有很多共同点的残疾。 这就是为什么在这两个领域的研究同时进行的原因。 为了 例如，通常会明确地诊断有机 这两种疾病的基础。 而且，心理 因素被牵涉到在 这些综合征的病因和维持。 也有很多 倡导治疗这些的心理和身体方法 疾病，尽管大多数尚未得到经验证明 成功。 此外，有增加的 这些疾病的明显患病率和感知的严重程度 过去的十年，它们使它们既昂贵又昂贵。 最后，参与TMD和慢性下背痛的工作 揭示了心理病理学的密切关系或合并症， 身体残疾。 这三个研究项目将进一步 探索这种合并症的性质。