Introduction

Neurofibromatoses (NFs; NF1, NF2 and Schwannomatosis) are incurable genetic syndromes characterized by nerve sheath tumors and often accompanied by substantial emotional distress (e.g., depression and anxiety). Pain is also common but understudied in adults with NF and interferes with daily living. In other medical populations, depression and anxiety have a strong association with pain interference. However, research has not explored the relationship of depression and anxiety to pain interference among adults with NF experiencing pain. The aim of this study was to test the hypothesis that depression and anxiety will mediate the association between pain intensity and pain interference among geographically diverse adults with NF who endorse pain.

Methods

We used baseline data from an RCT of a mind–body intervention aimed at improving quality of life in adults with NF. Participants (N = 214) who endorsed pain completed measures of demographics, clinical characteristics, baseline pain intensity, pain interference, depression, and anxiety. We constructed a multiple mediation model in R using the lavaan package to test our hypothesis.

Results

Preliminary analyses showed differences in pain interference by NF diagnostic subtype (F(2, 206) = 6.82, p = 001). In a model that controlled for NF diagnostic subtype, we found that depression (β = .07, p = .017), but not anxiety (β = -.003, p = .878), partially mediated the association between pain intensity and pain interference.

Conclusion

Improving depression has the potential to decrease pain interference among people with NF who experience pain.

Trial registration

Clinicaltrials.gov Registration #: NCT03406208

中文翻译：

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抑郁症解释了成人神经纤维瘤病疼痛强度与疼痛干扰之间的关联

介绍

神经纤维瘤病（NFs；NF1、NF2 和神经鞘瘤病）是无法治愈的遗传综合征，其特征是神经鞘瘤，并且通常伴有严重的情绪困扰（例如抑郁和焦虑）。疼痛在患有 NF 的成年人中也很常见，但尚未得到充分研究，并且会干扰日常生活。在其他医疗人群中，抑郁和焦虑与疼痛干扰密切相关。然而，研究尚未探讨抑郁和焦虑与患有 NF 疼痛的成年人的疼痛干扰之间的关系。本研究的目的是检验以下假设：抑郁和焦虑将介导疼痛强度和疼痛干扰之间的关联，这些关系在地理上不同的 NF 成年人中支持疼痛。

方法

我们使用了一项旨在改善 NF 成人生活质量的身心干预随机对照试验的基线数据。支持疼痛的参与者 ( N  = 214) 完成了人口统计学、临床特征、基线疼痛强度、疼痛干扰、抑郁和焦虑的测量。我们使用 lavaan 包在 R 中构建了一个多重中介模型来检验我们的假设。

结果

初步分析显示 NF 诊断亚型对疼痛干扰的差异 ( F (2, 206) = 6.82, p  = 001)。在一个控制 NF 诊断亚型的模型中，我们发现抑郁症 ( β  = .07, p  = .017)，而不是焦虑 ( β  = -.003, p  = .878)，部分介导了疼痛强度和疼痛干扰。

结论

改善抑郁症有可能减少经历疼痛的 NF 患者的疼痛干扰。

试用注册

Clinicaltrials.gov 注册号：NCT03406208