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缓解疼痛?一项基于人群的前瞻性研究:儿童期创伤暴露作为青年期频繁使用非处方镇痛药的预测因素。HUNT研究。

Killing pain? A prospective population-based study on trauma exposure in childhood as predictor for frequent use of over-the-counter analgesics in young adulthood. The HUNT study.

作者信息

Baumann-Larsen Monica, Zwart John-Anker, Dyb Grete, Wentzel-Larsen Tore, Stangeland Helle, Storheim Kjersti, Stensland Synne Øien

机构信息

Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

Psychiatry Res. 2023 Sep;327:115400. doi: 10.1016/j.psychres.2023.115400. Epub 2023 Aug 1.

DOI:10.1016/j.psychres.2023.115400
PMID:37574601
Abstract

Frequent and increasing use of over-the-counter analgesics (OTCA) is a public health concern. Pain conditions and psychological distress are related to frequent OTCA use, and as exposure to potentially traumatic events (PTE) in childhood appears to increase risk of experiencing such symptoms, we aimed to assess childhood PTEs and related symptoms in adolescence as predictors for frequent OTCA use in young adulthood. Prospective population survey data were used (n = 2947, 59.1% female, 10-13 years follow-up). Exposure to PTEs, symptoms of post-traumatic stress, anxiety and depression, musculoskeletal pain and headache were assessed in adolescence (13-19 years). Use of OTCA was assessed in young adulthood (22-32 years) and use of OTCA to treat musculoskeletal pain and headache served as separate outcomes in ordinal logistic regression analyses. Overall, exposure to childhood PTEs, particularly direct interpersonal violence, was significantly and consistently related to more frequent use of OTCA to treat musculoskeletal pain and headaches in young adulthood. Adjusting for psychological symptoms and pain attenuated associations, indicating that these symptoms are of importance for the relationship between traumatic events and OTCA use. These findings emphasize the need to address symptomatology and underlying causes at an early age.

摘要

非处方镇痛药(OTCA)的频繁且日益增加的使用是一个公共卫生问题。疼痛状况和心理困扰与OTCA的频繁使用有关,并且由于童年时期暴露于潜在创伤性事件(PTE)似乎会增加出现此类症状的风险,我们旨在评估青少年时期的童年PTE及其相关症状,作为年轻成年期频繁使用OTCA的预测因素。使用了前瞻性人群调查数据(n = 2947,59.1%为女性,随访10 - 13年)。在青少年时期(13 - 19岁)评估了暴露于PTE、创伤后应激、焦虑和抑郁症状、肌肉骨骼疼痛和头痛情况。在年轻成年期(22 - 32岁)评估了OTCA的使用情况,并且在有序逻辑回归分析中,将使用OTCA治疗肌肉骨骼疼痛和头痛作为单独的结果。总体而言,童年时期暴露于PTE,尤其是直接的人际暴力,与年轻成年期更频繁地使用OTCA治疗肌肉骨骼疼痛和头痛显著且持续相关。对心理症状和疼痛进行调整后,关联减弱,表明这些症状对于创伤性事件与OTCA使用之间的关系很重要。这些发现强调了在早期解决症状和潜在原因的必要性。

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