Division on Substance Use Disorders, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York.
Translational Research Training Program in Addiction, City College of New York, New York.
Am J Addict. 2017 Dec;26(8):815-821. doi: 10.1111/ajad.12637. Epub 2017 Nov 21.
While research on the separate relationships between health-related quality of life (HRQOL) and chronic pain, and HRQOL and opioid abuse has been sparse, even less work has investigated the factors associated with HRQOL in individuals who have both chronic pain and meet criteria for opioid use disorder. The data presented in this analysis should allow a better understanding the factors important to quality of life among this dual-diagnosed population.
Individuals with dual diagnoses of chronic pain and opioid use disorder were recruited for clinical research studies at Columbia University Medical Center. Participants (n = 47) completed inventories to assess pain (Brief Pain Inventory), opioid (ab)use, and depression (Beck Depression Inventory). Variable from these and other inventories, along with demographic factors (age, race, sex, pain severity, depressive symptoms, duration of opioid use, route of opioid use, amount of opioid use) were entered into a regression analysis in order to identify the strongest predictors of SF-36 Health Survey score.
In the bivariate analysis we found that demographic and drug use variables were rarely associated with HRQOL. Typically, ratings of pain severity and pain interference were the best predictors. In the multivariate analysis, we found that across the several HRQOL dimensions greater Brief Pain Inventory (BPI) ratings of pain "interference" and Beck Depression Inventory (BDI) scores were consistently associated with lower HRQOL.
These data suggest that insufficient pain management and depression are significant variables contributing to lower quality of life among individuals with chronic pain and opioid use disorder. (Am J Addict 2017;26:815-821).
虽然健康相关生活质量(HRQOL)与慢性疼痛之间以及 HRQOL 与阿片类药物滥用之间的关系的研究较少,但对于同时患有慢性疼痛且符合阿片类药物使用障碍标准的个体,与 HRQOL 相关的因素的研究则更少。本分析中提供的数据应能更好地了解该双重诊断人群生活质量的重要因素。
哥伦比亚大学医学中心招募了患有慢性疼痛和阿片类药物使用障碍双重诊断的个体参加临床研究。参与者(n=47)完成了评估疼痛(简明疼痛量表)、阿片类药物(滥用)和抑郁(贝克抑郁量表)的量表。这些和其他量表的变量,以及人口统计学因素(年龄、种族、性别、疼痛严重程度、抑郁症状、阿片类药物使用时间、阿片类药物使用途径、阿片类药物使用量)被纳入回归分析,以确定 SF-36 健康调查评分的最强预测因子。
在单变量分析中,我们发现人口统计学和药物使用变量与 HRQOL 很少相关。通常,疼痛严重程度和疼痛干扰的评分是最佳预测因子。在多变量分析中,我们发现,在几个 HRQOL 维度中,简明疼痛量表(BPI)疼痛“干扰”评分和贝克抑郁量表(BDI)评分越高,HRQOL 越低。
这些数据表明,疼痛管理不足和抑郁是导致患有慢性疼痛和阿片类药物使用障碍的个体生活质量较低的重要因素。