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老年慢性疼痛患者的抑郁和阿片类药物滥用:潜在类别分析。

Depression and Opioid Misuse in Elderly Individuals With Chronic Pain: A Latent Class Analysis.

机构信息

School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China.

School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China.

出版信息

Pain Manag Nurs. 2022 Oct;23(5):602-607. doi: 10.1016/j.pmn.2022.02.003. Epub 2022 Mar 10.

Abstract

BACKGROUND

Chronic pain patients tend to have comorbid depressive symptoms, and empirical data investigating differences related to depressive symptoms classes and opioid misuse are scant.

AIMS

The aim of this study was to identify heterogeneous depressive symptoms trajectories in elderly individuals with chronic pain who take opioids, and investigate the association between depressive symptoms subgroups and opioid misuse.

DESIGN

Secondary data analysis of a cross-sectional study.

SETTINGS

Twelve communities were selected from a city in Shandong Province, China, using multi-stage cluster sampling.

PARTICIPANTS/SUBJECTS: Individuals aged ≥60 years with self-reported chronic pain lasting more than one year and who took opioids under prescription were screened.

METHODS

Latent class analysis was used to identify homogeneous depressive symptoms groups within the elderly population with chronic pain. Multinomial logistic regression, and one-way analysis of variance were also performed.

RESULTS

The best-fitted model suggested three depressive symptoms subgroups: "Impaired Memory," "Perceived Stress in Life and Work," and "Low Mood." Age, education level, and marital status were depression risk factors. The odds of opioid misuse varied among the depressive symptoms subgroups.

CONCLUSIONS

These findings may help improve depressive symptoms and chronic pain management by identifying high-risk elderly individuals for early intervention and personalizing treatment according to the depressive symptoms subgroup and severity of opioid misuse.

摘要

背景

慢性疼痛患者往往伴有共病抑郁症状,而关于与抑郁症状类别和阿片类药物滥用相关差异的实证数据却很少。

目的

本研究旨在确定服用阿片类药物的老年慢性疼痛患者中存在的异质抑郁症状轨迹,并探讨抑郁症状亚组与阿片类药物滥用之间的关系。

设计

横断面研究的二次数据分析。

地点

采用多阶段聚类抽样,从中国山东省的一个城市中选择了 12 个社区。

参与者/受试者:筛选出年龄≥60 岁、自述患有慢性疼痛持续一年以上且根据处方服用阿片类药物的人群。

方法

采用潜在类别分析识别慢性疼痛老年人群中同质的抑郁症状组。还进行了多项逻辑回归和单因素方差分析。

结果

最佳拟合模型提示存在三种抑郁症状亚组:“记忆障碍”、“生活和工作中的感知压力”和“情绪低落”。年龄、教育水平和婚姻状况是抑郁的风险因素。阿片类药物滥用的几率在抑郁症状亚组之间存在差异。

结论

这些发现可以通过识别高风险的老年个体进行早期干预,并根据抑郁症状亚组和阿片类药物滥用的严重程度进行个体化治疗,从而有助于改善抑郁症状和慢性疼痛管理。

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