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阿片类戒断表现的临床有意义的个体差异。

Clinically meaningful individual differences in opioid withdrawal expression.

机构信息

School of Social Work, University of North Carolina at Chapel Hill.

Department of Psychiatry and Behavioral Sciences, Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine.

出版信息

Exp Clin Psychopharmacol. 2023 Dec;31(6):1005-1009. doi: 10.1037/pha0000654. Epub 2023 May 11.

Abstract

Opioid use disorder (OUD) is a significant public health concern. An individual with an OUD may experience withdrawal after stopping opioid use. There has been limited exploration of the individual differences in withdrawal expression. This study expands understanding of this issue by examining the presence and frequency at which persons who have ever had opioid withdrawal have experienced different opioid withdrawal symptoms. Using cross-sectional data captured online from Amazon Mechanical Turk, 124 adults with a lifetime experience of opioid withdrawal were included. Respondents were able to indicate ever experiencing 31 individual opioid withdrawal symptoms. If a symptom was ever experienced, respondents would indicate if it was common and whether it bothered them. A cluster analysis was used to explore variability between the withdrawal symptoms. The sample was primarily men ( = 76, 61.3%) with an average age of 34.7 ( = 11.6). The typical withdrawal syndrome lasted 6.5 days ( = 4.9) and was most severe at 5.7 ( = 4.9) days. Lifetime endorsement of individual symptoms ranged from a high of 73.4% (anxious) to a low of 43.5% (nausea). The cluster analysis was significant, (1, 122) = 215.6, < .001, with good Bayesian information criteria (0.7). The two clusters are conceptualized here as HIGH ( = 73; 59%) and LOW ( = 51; 41%) endorsing, with a mean of 21.9 and 8.5 items endorsed. These data add to prior studies by suggesting high variability in the individual expression of opioid withdrawal symptoms. It may be time for the field to develop a consensus regarding opioid withdrawal symptom expression and measurement to enhance clinical care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

阿片类药物使用障碍(OUD)是一个重大的公共卫生问题。有 OUD 的个体在停止使用阿片类药物后可能会经历戒断。对于戒断表现的个体差异,研究还很有限。本研究通过检查曾经经历过阿片类药物戒断的人经历不同阿片类药物戒断症状的存在和频率,扩展了对这一问题的理解。使用从亚马逊 Mechanical Turk 在线捕获的横断面数据,纳入了 124 名有终生阿片类药物戒断经历的成年人。受访者能够表明他们是否曾经历过 31 种不同的阿片类药物戒断症状。如果曾经经历过某种症状,受访者会表明它是否常见以及是否困扰他们。聚类分析用于探索戒断症状之间的可变性。样本主要是男性(n = 76,61.3%),平均年龄为 34.7(= 11.6)。典型的戒断综合征持续 6.5 天(= 4.9),在第 5.7 天(= 4.9)最严重。终生对个体症状的认可范围从 73.4%(焦虑)的高值到 43.5%(恶心)的低值。聚类分析具有统计学意义,(1,122)= 215.6, <.001,贝叶斯信息标准良好(0.7)。这两个聚类在这里被概念化为 HIGH(n = 73;59%)和 LOW(n = 51;41%),分别有 21.9 项和 8.5 项被认可。这些数据通过表明阿片类药物戒断症状的个体表达存在高度可变性,为先前的研究增添了内容。现在可能是该领域就阿片类药物戒断症状的表达和测量达成共识的时候了,以加强临床护理。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。

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