Hindmarch Grace, Meredith Lisa S, McCullough Colleen M, Griffin Beth Ann, Watkins Katherine E
Health Care Division, RAND, Santa Monica, CA, USA.
RAND Corporation, Arlington, VA, USA.
Chronic Stress (Thousand Oaks). 2024 Sep 5;8:24705470241279335. doi: 10.1177/24705470241279335. eCollection 2024 Jan-Dec.
UNLABELLED: Interpersonal violence is a common type of trauma experienced by people with opioid use disorder (OUD), especially for people with co-occurring OUD and mental illness (COD). However, little is known about demographic and clinical characteristics of individuals with COD who have experienced an interpersonal violence traumatic event compared to those who have experienced a non-violent trauma, and how experiences of interpersonal violence are associated with treatment utilization. Data presented are from a randomized clinical trial testing collaborative care for COD in primary care. Of the 797 patients enrolled in the larger study, 733 (92%) were included in this analysis because they reported a traumatic event. In this sample, 301 (41%) participants experienced a traumatic event involving interpersonal violence. Participants who experienced interpersonal violence were more likely to be younger and female. Among the 301 people who experienced interpersonal violence, 30% experienced child sexual abuse, 23% experienced physical violence, 19% experienced domestic violence, and 28% experienced sexual assault. Those who experienced physical violence were significantly less likely to be female (28.6% vs 74.2% to 88.2% in other groups). Those who reported domestic violence had significantly fewer days of drug use (4.1 days vs 9.0 to 11.5 in the other groups) and lower opioid use severity scores (mean = 13.0 vs 16.6 to 19.5 in the other groups). Multivariable regression results examining the associations between interpersonal violence experiences on treatment utilization revealed no statistically significant differences. Rates of receipt were high for medication for opioid use disorder (∼80%) in this sample while rates of mental health counseling were around 35% and rates of receiving mental health medication around 48%. These findings make an important contribution to understanding the associations between patient characteristics and traumatic experiences, and receipt of treatment for OUD and mental health problems among a sample of patients with COD. CLINICAL TRIAL REGISTRATION: clinicalTrials.gov ID: NCT04559893.
未标注：人际暴力是阿片类物质使用障碍（OUD）患者常见的一种创伤类型，对于同时患有OUD和精神疾病（COD）的患者尤为如此。然而，与经历非暴力创伤的COD患者相比，经历人际暴力创伤事件的COD患者的人口统计学和临床特征，以及人际暴力经历与治疗利用之间的关系鲜为人知。所呈现的数据来自一项在初级保健中测试针对COD的协作式护理的随机临床试验。在参与更大规模研究的797名患者中，733名（92%）因报告了创伤事件而被纳入本分析。在这个样本中，301名（41%）参与者经历了涉及人际暴力的创伤事件。经历人际暴力的参与者更可能是年轻人且为女性。在经历人际暴力的301人中，30%经历过儿童性虐待，23%经历过身体暴力，19%经历过家庭暴力，28%经历过性侵犯。经历身体暴力的人女性比例显著更低（28.6%，而其他组为74.2%至88.2%）。报告家庭暴力的人吸毒天数显著更少（4.1天，而其他组为9.0至11.5天），且阿片类物质使用严重程度得分更低（均值 = 13.0，而其他组为16.6至19.5）。检验人际暴力经历与治疗利用之间关联的多变量回归结果显示无统计学显著差异。在这个样本中，阿片类物质使用障碍药物的接受率较高（约80%），而心理健康咨询率约为35%，接受心理健康药物的比率约为48%。这些发现对于理解患者特征与创伤经历之间的关联，以及在一组COD患者样本中OUD和心理健康问题的治疗接受情况做出了重要贡献。 临床试验注册：clinicalTrials.gov标识符：NCT04559893。
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