Division of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention.
Division of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention.
J Affect Disord. 2022 Dec 1;318:16-21. doi: 10.1016/j.jad.2022.08.115. Epub 2022 Aug 31.
Previous research has shown an association between psychological distress and overdose death among specific populations. However, few studies have examined this relationship in a large US population-based cohort.
Data from the 2010-2018 NHIS were linked to mortality data from the National Death Index through 2019. Psychological distress was measured using the Kessler 6 scale. Drug overdose deaths were examined, and deaths from all other causes were included as a comparison group. Cox proportional hazards regression was used to estimate mortality risk by psychological distress level.
The study population included 272,561 adults. Adjusting for demographic covariates and using no psychological distress as the reference, distress level was positively associated with the risk of overdose death: low (HR = 1.8, 95 % CI = 1.1-2.8), moderate (HR = 4.1, 95 % CI = 2.5-6.7), high (HR = 10.3, 95 % CI = 6.5-16.1). A similar pattern was observed for deaths from all other causes: low (HR = 1.2, 95 % CI = 1.1-1.2), moderate (HR = 1.9, 95 % CI = 1.7-2.0), high (HR = 2.6, 95 % CI = 2.4-2.8).
Limited substance use information prevented adjustment for this potentially important covariate.
Adults with psychological distress were at greater risk of drug overdose death, relative to those without psychological distress. Adults with psychological distress were also at increased risk of death due to other causes, though the association was not as strong.
先前的研究表明，在某些特定人群中，心理困扰与过量用药死亡之间存在关联。然而，很少有研究在大规模的美国人群队列中检验这种关系。
将 2010 年至 2018 年全国健康访谈调查（NHIS）的数据与 2019 年国家死亡指数的死亡率数据进行关联。使用 Kessler 6 量表来衡量心理困扰程度。研究考察了药物过量死亡，并将所有其他原因导致的死亡作为对照组。使用 Cox 比例风险回归来估计按心理困扰程度分层的死亡率风险。
研究人群包括 272561 名成年人。在调整人口统计学协变量后，以无心理困扰作为参考，发现困扰程度与过量用药死亡风险呈正相关：轻度（HR=1.8，95%置信区间[CI]：1.1-2.8）、中度（HR=4.1，95%CI：2.5-6.7）、重度（HR=10.3，95%CI：6.5-16.1）。对于所有其他原因导致的死亡，也观察到类似的模式：轻度（HR=1.2，95%CI：1.1-1.2）、中度（HR=1.9，95%CI：1.7-2.0）、重度（HR=2.6，95%CI：2.4-2.8）。
有限的物质使用信息使我们无法对这一潜在重要的协变量进行调整。
与无心理困扰的成年人相比，有心理困扰的成年人发生药物过量用药死亡的风险更高。有心理困扰的成年人因其他原因导致的死亡风险也有所增加，尽管这种关联没有那么强。
