Pestka Elizabeth L, Craner Julia, Evans Michele, Nash Virginia, Kimondo Njoki, Pestka Deborah, Loukianova Larissa, Sperry Jeannie
Department of Psychiatry, Mayo Clinic, Rochester, Minnesota.
Department of Psychiatry and Behavioral Medicine, Spectrum Health System, Grand Rapids, Michigan.
Pain Manag Nurs. 2018 Apr;19(2):115-124. doi: 10.1016/j.pmn.2017.09.007. Epub 2017 Nov 15.
The objectives of this study were to examine association between a family history of substance abuse and admission morphine equivalent dose, depression and pain catastrophizing screening scores, as well as reported personal history of substance use. The retrospective research was completed in an interdisciplinary three-week pain rehabilitation center. The subject cohort included admissions from January through December 2014 with 351 datasets for family history of substance abuse and oral morphine equivalency and 341 for depression, pain catastrophizing and use of substances. Outcome measures included admission self-reported data on family history of substance abuse and past and current substance use, admission morphine equivalency dose, and scores on the Center for Epidemiologic Studies-Depression Scale and the Pain Catastrophizing Scale. One hundred forty-seven patients were using opioid medications on admission and those with a positive family history of substance abuse had an oral morphine equivalency (M = 92.12, SD = 95.32) compared to a negative history (M = 80.34, SD = 64.86); the difference was not statistically significant, t (120.01) =.87, p = .39. Patients with a positive family history reported higher levels of both depression, t (327.40) = 3.15, p = .002 and pain catastrophizing, t (338) = 2.76, p = .01. Those with a positive family history endorsed greater frequency of past alcohol use χ (1, N = 326) = 6.67, p = 0.1 and marijuana use χ (1, N = 341) = 4.23, p = .04 and past χ (1, N = 329) = 9.90, p = .002 and current tobacco use χ (1, N = 327) = 8.81, p = .003. Use of family history of substance abuse information may help provide data for multimodal treatments of chronic non-cancer-pain. The findings from this study can be used to guide future research.
本研究的目的是探讨药物滥用家族史与入院时吗啡等效剂量、抑郁及疼痛灾难化筛查评分之间的关联,以及报告的个人药物使用史。这项回顾性研究在一个跨学科的为期三周的疼痛康复中心完成。研究对象队列包括2014年1月至12月的入院患者,其中351个数据集涉及药物滥用家族史和口服吗啡等效剂量,341个数据集涉及抑郁、疼痛灾难化及药物使用情况。结果指标包括入院时自我报告的药物滥用家族史及过去和当前的药物使用情况、入院时吗啡等效剂量,以及流行病学研究中心抑郁量表和疼痛灾难化量表的评分。147名患者入院时正在使用阿片类药物,药物滥用家族史呈阳性的患者口服吗啡等效剂量为(M = 92.12,SD = 95.32),而家族史呈阴性的患者为(M = 80.34,SD = 64.86);差异无统计学意义,t(120.01) = 0.87,p = 0.39。药物滥用家族史呈阳性的患者报告的抑郁水平更高,t(327.40) = 3.15,p = 0.002,疼痛灾难化水平也更高,t(338) = 2.76,p = 0.01。家族史呈阳性的患者认可过去饮酒频率更高,χ(1,N = 326) = 6.67,p = 0.1,大麻使用频率更高,χ(1,N = 341) = 4.23,p = 0.04,过去吸烟频率更高,χ(1,N = 329) = 9.90,p = 0.002,当前吸烟频率更高,χ(1,N = 327) = 8.81,p = 0.003。利用药物滥用家族史信息可能有助于为慢性非癌性疼痛的多模式治疗提供数据。本研究结果可用于指导未来的研究。