Salivary cortisol and psychological mechanisms in patients with acute versus chronic low back pain

被引：35

作者：

Sudhaus, Sigrid ^{[1
]}

Fricke, Britta ^{[2
]}

Stachon, Axel ^{[3
]}

Schneider, Stefan ^{[4
]}

Klein, Harald ^{[4
]}

von Duering, Monika ^{[2
]}

Hasenbring, Monika ^{[1
]}

机构：

[1] Ruhr Univ Bochum, Dept Med Psychol & Med Sociol, Fac Med, D-44780 Bochum, Germany

[2] Ruhr Univ Bochum, Dept Neuroanat & Mol Brain Res, Fac Med, D-44780 Bochum, Germany

[3] Ruhr Univ Bochum, BG Univ Hosp Bergmannsheil, Inst Clin Chem Transfus & Lab, D-44789 Bochum, Germany

[4] Ruhr Univ Bochum, BG Univ Hosp Bergmannsheil, Dept Med 1, Div Endocrinol & Metab, D-44789 Bochum, Germany

来源：

PSYCHONEUROENDOCRINOLOGY | 2009年 / 34卷 / 04期

关键词：

Cortisol; Acute and chronic low back pain; Pain-related coping; Nonverbal pain behavior; Depressive mood; Fatigue; COGNITIVE ACTIVATION THEORY; PITUITARY-ADRENAL AXIS; RISK-FACTORS; FEAR-AVOIDANCE; STRESS; FATIGUE; INVENTORY; DEPRESSION; FIBROMYALGIA; RESPONSES;

D O I：

10.1016/j.psyneuen.2008.10.011

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

This study was designed to explore whether the basal adrenocortical activity is related with pain-retated coping, nonverbal pain behavior, depressive mood, and fatigue in patients with acute and chronic nonspecific low back pain. 19 patients with acute low back pain (ALBP) and 24 with chronic low back pain (CLBP) participated in the study. The adrenocortical activity was assessed through the cortisol awakening response. All participants provided five saliva samples (0, 15, 30, 45, and 60 min after waking) on two consecutive days off work. Pain-related coping [fear-avoidance coping (FAC) and endurance coping (EC)], nonverbal pain behavior (NPB), depressive mood, and fatigue were assessed through questionnaires. Among ALPB patients, EC was negatively associated with the cortisol release, whereas fatigue was positively associated with it. Among CLBP patients, FAC, NPB, depressive mood, and fatigue were negatively associated with the cortisol awakening response, whereas EC tended to be positively associated with it. The results indicate that pain-related coping strategies which are expected to be successful appear to lower the adrenocortical activity among ALBP patients, whereas affective distress may enhance the level of cortisol in this group. Among CLBP patients, long-term maladaptive coping strategies might contribute to hypocortisolism. (C) 2008 Elsevier Ltd. All rights reserved.

引用

页码：513 / 522

页数：10

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