Abstract

Background

Pain is a common symptom in pediatric inflammatory bowel disease (IBD) and is associated with poor health outcomes, yet additional knowledge about the psychosocial correlates of pain is needed to optimize clinical care. The purpose of this study is to systematically review the psychosocial factors associated with pain and pain impact in youth diagnosed with IBD within a developmentally informed framework.

Methods

Manual and electronic searches yielded 2641 references. Two authors conducted screening (98% agreement), and data extraction was performed in duplicate. Average study quality was rated using the National Institutes of Health Quality Assessment Tool.

Results

Ten studies (N = 763 patients; N = 563 Crohn disease, N = 200 ulcerative/ indeterminate colitis) met the inclusion criteria. Findings showed consistent evidence that higher levels of child depression symptoms and child pain catastrophizing were associated with significantly greater pain and pain impact (magnitude of association ranged from small to large across studies). Greater pain and pain impact were also associated with higher levels of child anxiety symptoms, child pain threat, child pain worry, and parent pain catastrophizing. Within the included studies, female sex and disease severity were both significantly associated with pain and pain impact. Study quality was moderate on average.

Conclusions

There is evidence that child psychosocial factors are associated with pain and pain impact in pediatric IBD; more studies are needed to examine parent- and family-level psychosocial factors. Youth with IBD should be routinely screened for pain severity, pain impact, and psychosocial risk factors such as anxiety/depression.

中文翻译：

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系统评价：小儿炎症性肠病疼痛的心理社会相关性

摘要

背景

疼痛是小儿炎症性肠病 (IBD) 的常见症状，与健康状况不佳有关，但需要更多关于疼痛的心理社会相关性的知识来优化临床护理。本研究的目的是在发育知情的框架内系统地回顾与疼痛和疼痛影响相关的心理社会因素，这些因素对被诊断患有 IBD 的青年人产生了影响。

方法

手动和电子搜索产生了 2641 条参考文献。两位作者进行了筛选（98% 的一致性），数据提取一式两份。使用美国国立卫生研究院质量评估工具对平均研究质量进行评级。

结果

十项研究（N = 763 名患者；N = 563 例克罗恩病，N = 200 例溃疡性/不确定性结肠炎）符合纳入标准。研究结果显示一致的证据表明，较高水平的儿童抑郁症状和儿童疼痛灾难性与显着更大的疼痛和疼痛影响相关（相关程度在研究中从小到大不等）。更大的疼痛和疼痛影响也与更高水平的儿童焦虑症状、儿童疼痛威胁、儿童疼痛担忧和父母疼痛灾难性相关。在纳入的研究中，女性性别和疾病严重程度都与疼痛和疼痛影响显着相关。平均研究质量中等。

结论

有证据表明儿童心理社会因素与儿童 IBD 的疼痛和疼痛影响有关；需要更多的研究来检验父母和家庭层面的社会心理因素。应定期筛查 IBD 青少年的疼痛严重程度、疼痛影响和心理社会风险因素，如焦虑/抑郁。