National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.
School of Psychology, The University of Queensland, St Lucia, Australia.
Pain Med. 2022 Aug 1;23(8):1442-1456. doi: 10.1093/pm/pnac029.
To review evidence from longitudinal studies on the association between prescription opioid use and common mood and anxiety symptoms.
We conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
We searched PubMed, Embase, and PsycINFO for search terms related to opioids AND (depression OR bipolar OR anxiety OR post-traumatic stress disorder [PTSD]). Findings were summarized narratively, and random-effects meta-analyses were used to pool effect sizes.
We identified 10,290 records and found 10 articles that met our inclusion criteria. Incidence studies showed that people who used prescription opioids had an elevated risk of any mood outcome (adjusted effect size [aES] = 1.80 [95% confidence interval = 1.40-2.30]) and of an anxiety outcome (aES = 1.40 [1.20-1.80]) compared with those who did not use prescription opioids. Associations with depression were small and not significant after adjustment for potential confounders (aES = 1.18 [0.98-1.41]). However, some studies reported an increased risk of depressive symptoms after increased (aES = 1.58 [1.30-1.93]) or prolonged opioid use (aES = 1.49 [1.19-1.86]).
Mental health should be considered when opioids are prescribed because some patients could be vulnerable to adverse mental health outcomes.
综述关于处方类阿片使用与常见心境和焦虑症状之间关联的纵向研究证据。
我们根据系统评价和荟萃分析首选报告项目（PRISMA）指南进行了系统评价和荟萃分析。
我们在 PubMed、Embase 和 PsycINFO 中搜索了与阿片类药物相关的术语和（抑郁、双相、焦虑、创伤后应激障碍[PTSD]）。结果以叙述性方式进行总结，并使用随机效应荟萃分析来汇总效应大小。
我们确定了 10290 条记录，找到了 10 篇符合我们纳入标准的文章。发病研究表明，与未使用处方类阿片的人相比，使用处方类阿片的人发生任何心境结局的风险升高（调整后的效应大小[aES] = 1.80[95%置信区间=1.40-2.30]）和焦虑结局的风险升高（aES = 1.40[1.20-1.80]）。在调整了潜在混杂因素后，与抑郁相关的关联较小且无统计学意义（aES = 1.18[0.98-1.41]）。然而，一些研究报告称，在增加（aES = 1.58[1.30-1.93]）或延长阿片类药物使用后，出现抑郁症状的风险增加（aES = 1.49[1.19-1.86]）。
开具阿片类药物时应考虑心理健康问题，因为一些患者可能容易受到不良心理健康结局的影响。
