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在初级保健中接受阿片类物质使用障碍药物治疗的患者心理健康和幸福感的纵向评估。

Longitudinal assessment of mental health and well-being in patients being treated with medications for opioid use disorder in primary care.

作者信息

Hooker Stephanie A, Lonergan-Cullum Mary, Levy Robert, Nissly Tanner, Sherman Michelle D

机构信息

HealthPartners Institute, Research Division, 8170 E 33 Ave, Mail Stop 21112R, Minneapolis, MN 55440, United States.

University of Minnesota, Department of Family Medicine and Community Health, 516 Delaware St SE, 6-240 Phillips-Wangensteen Building, Minneapolis, MN 55455, United States.

出版信息

Addict Behav Rep. 2021 Apr 23;13:100348. doi: 10.1016/j.abrep.2021.100348. eCollection 2021 Jun.

Abstract

Opioid use disorder (OUD) continues to be a significant problem in the United States, contributing to overdose and death. Recent efforts to expand access to treatment of OUD in primary care have increased the availability of medications for OUD (MOUDs). However, OUD is often accompanied by poor mental health and well-being, and it is not known if treatment with MOUDs alone is associated with improved psychological well-being. This study's purpose was to examine changes in mental health and well-being in the first 6 months of treatment with MOUDs in a family medicine residency clinic. Patients ( = 126; age = 34.6 years,  = 10.6; 54.8% male; 71.4% white) completed validated screeners of mental health and well-being (depression, anxiety, anger, loneliness, perceived stress, meaning in life, and life satisfaction) at baseline (induction visit for buprenorphine), 1-month, and 6-months. Results indicated that the mental health and well-being indices did not significantly change over the first 6 months of treatment on MOUDs. There were initial decreases in depression and anxiety at 1-month; however, both increased and were equivalent to baseline levels at 6-months. These results suggest that MOUD treatment alone does not significantly impact mental health or well-being in patients with OUD. Additional treatments or supports are clearly needed to address the comorbid mental health and well-being challenges in this population, as these factors can be both antecedents and consequences of substance misuse.

摘要

阿片类药物使用障碍(OUD)在美国仍然是一个严重问题,导致过量用药和死亡。近期在初级保健中扩大OUD治疗可及性的努力增加了用于治疗OUD的药物(MOUDs)的可获得性。然而,OUD常常伴有心理健康状况不佳和幸福感缺失,目前尚不清楚仅使用MOUDs进行治疗是否与心理健康状况改善相关。本研究的目的是在一家家庭医学住院医师诊所中,考察使用MOUDs治疗的前6个月内患者心理健康和幸福感的变化。患者(n = 126;年龄 = 34.6岁,标准差 = 10.6;54.8%为男性;71.4%为白人)在基线(丁丙诺啡诱导访视)、1个月和6个月时完成了心理健康和幸福感的有效筛查(抑郁、焦虑、愤怒、孤独感、感知压力、生活意义和生活满意度)。结果表明,在使用MOUDs治疗的前6个月内,心理健康和幸福感指标没有显著变化。在1个月时抑郁和焦虑最初有所下降;然而,两者在6个月时均有所上升且与基线水平相当。这些结果表明,仅使用MOUDs治疗对患有OUD的患者的心理健康或幸福感没有显著影响。显然需要额外的治疗或支持来应对该人群中并存的心理健康和幸福感挑战,因为这些因素可能既是药物滥用的前因也是后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64f7/8105616/83e75ac3445f/gr1.jpg

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