Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt (MA, SI, EF), Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt (AS), 2015-2016 Hubert H. Humphrey Fellowship, Department of Psychology, Virginia Commonwealth University, Richmond, VA (MA).
J Addict Med. 2020 Dec;14(6):e330-e336. doi: 10.1097/ADM.0000000000000670.
Individuals with chronic pain are at higher risk for suicide than other populations, and their potential for prescription drug use disorder (PDUD) enormously exists. This study aimed to estimate the prevalence and correlates of suicidality and to determine its relation to PDUD, among US adults with a history of chronic pain.
Data were obtained from the Collaborative Psychiatric Epidemiology Surveys (2001-2003). This analysis was limited to respondents who had a history of chronic pain (N = 5301). Logistic regression was used to determine the association between suicidality and prescription drug use disorder among those populations.
Among study respondents, there was a strong positive association between PDUD and suicidal ideation and attempts (P value < 0.001, = 0.006, respectively). Adjusted logistic regression analysis showed those with PDUD had 1.5 times greater likelihood of suicidal ideation (95% CI 1.2-1.8). Among respondents with a history of chronic pain and PDUD, Non-Hispanic Whites, female gender, lifetime mood and/or anxiety, and substance use disorders were associated with increased suicide risk (P value = 0.020, = 0.011, < 0.001, < 0.001, respectively).
There is a robust relationship between PDUD and suicidality in US adults with a history of chronic pain. Ethnicity, gender, and comorbid mood, anxiety or substance use disorders can predict suicidality among individuals with both chronic pain and PDUD. Longitudinal studies need to investigate the causal relationship between PDUD and suicidality among those populations.
患有慢性疼痛的个体自杀风险高于其他人群，且他们存在极大的处方药物使用障碍（PDUD）风险。本研究旨在评估美国有慢性疼痛史的成年人中自杀意念和自杀企图的流行率和相关因素，并确定其与 PDUD 的关系。
数据来自合作精神流行病学调查（2001-2003 年）。本分析仅限于有慢性疼痛史的受访者（N=5301）。采用 logistic 回归确定这些人群中 PDUD 与自杀意念和自杀企图之间的关系。
在研究受访者中，PDUD 与自杀意念和自杀企图之间存在很强的正相关（P 值均<0.001，=0.006）。调整后的 logistic 回归分析显示，PDUD 患者自杀意念的可能性增加了 1.5 倍（95%CI 1.2-1.8）。在有慢性疼痛和 PDUD 史的受访者中，非西班牙裔白人、女性、终身心境和/或焦虑障碍以及物质使用障碍与自杀风险增加相关（P 值分别为=0.020、=0.011、<0.001、<0.001）。
美国有慢性疼痛史的成年人中，PDUD 与自杀意念和自杀企图之间存在密切关系。种族、性别以及合并的心境、焦虑或物质使用障碍可以预测有慢性疼痛和 PDUD 的个体的自杀意念。需要进行纵向研究来调查这些人群中 PDUD 与自杀意念之间的因果关系。
