Kitsantas Panagiota, Adams Amy R, Cheema Jehanzeb, Kornides Melanie L
Department of Health Administration and Policy, George Mason University, 4400 University Dr, Fairfax, VA, MS 1J322030-4444, USA.
Department of Global and Community Health, George Mason University, 4400 University Dr., Fairfax, VA, 22030, USA.
Arch Gynecol Obstet. 2021 Jun;303(6):1531-1537. doi: 10.1007/s00404-020-05953-0. Epub 2021 Jan 10.
The purpose of this study was to examine associations between opioid use and the degree of mental health-related disability due to emotional/behavioral problems as measured by the World Health Organization Disability Assessment Schedule (WHODAS) instrument in a national sample of pregnant women.
We used data from the National Survey on Drug Use and Health 2014-2017 which included 2,888 pregnant women 18 years or older. The WHODAS instrument was utilized to measure disability as the degree of functional impairment due to emotional/behavioral problems experienced by the respondent. Multinomial logistic regression models were built to assess the magnitude and direction of the association between severity of mental health-related disability with opioid use and abuse/dependency in the past year.
Approximately 30% of pregnant women suffered from moderate/severe mental health-related disability, and 2% reported opioid abuse/dependency. Compared to those with no opioid use, the odds of opioid use in the past year for individuals with moderate/severe mental health-related disability were 1.73 (95% CI 1.36, 2.21) times higher than those with no/mild disability. Similarly, the odds of opioid abuse/dependency were at least three times higher (OR 3.51; 95% CI 1.80, 6.84) among those with moderate/severe mental health-related disability relative to pregnant women with no/mild disability.
Clinicians should consider screening for both opioid use and mental health conditions and related disabilities using screening tools such as the WHODAS during the initial prenatal visits.
本研究旨在通过世界卫生组织残疾评定量表（WHODAS），在全国范围内的孕妇样本中，研究阿片类药物使用与因情绪/行为问题导致的心理健康相关残疾程度之间的关联。
我们使用了2014 - 2017年全国药物使用和健康调查的数据，其中包括2888名18岁及以上的孕妇。WHODAS用于衡量残疾程度，即受访者因情绪/行为问题所经历的功能损害程度。构建多项逻辑回归模型，以评估过去一年中与心理健康相关的残疾严重程度与阿片类药物使用及滥用/依赖之间关联的大小和方向。
约30%的孕妇患有中度/重度心理健康相关残疾，2%报告有阿片类药物滥用/依赖。与未使用阿片类药物的孕妇相比，过去一年中患有中度/重度心理健康相关残疾的孕妇使用阿片类药物的几率比无/轻度残疾的孕妇高1.73倍（95%可信区间1.36, 2.21）。同样，与无/轻度残疾的孕妇相比，患有中度/重度心理健康相关残疾的孕妇阿片类药物滥用/依赖的几率至少高3倍（比值比3.51；95%可信区间1.80, 6.84）。
临床医生应在初次产前检查时，考虑使用WHODAS等筛查工具，对阿片类药物使用及心理健康状况和相关残疾进行筛查。
