■有新的证据表明,创伤后应激障碍可能在慢性非癌症疼痛和阿片类药物使用障碍的发展中具有独立的中介作用,但其对慢性非癌症性疼痛患者阿片类药物使用障碍发展的影响仍不清楚。
■(i)估计患有慢性非癌症疼痛和创伤后应激障碍的个体中阿片类药物使用障碍的风险,相对于那些只有慢性非癌症疼痛的人,(ii)确定慢性非癌症疼痛和创伤后应激障碍患者中阿片类药物使用障碍的潜在相关性。
■本系统评价按照系统评价和荟萃分析指南的首选报告项目进行。纵向,流行病学,队列,后续行动,回顾性,从六个电子数据库中确定了前瞻性和横断面研究,这些研究报告了慢性非癌症疼痛患者中发生阿片类药物使用障碍与创伤后应激障碍的可能性差异的测量(Medline,Embase,循证医学综述,PsycINFO,Scopus和WebofScience),直到2022年12月。
■四项研究中有三项,符合本分析的选择标准的研究报告,慢性非癌症疼痛队列中发生阿片类药物使用障碍的风险与创伤后应激障碍之间存在统计学上显著的正相关(未调整的相对风险范围:1.51-5.27),但这种关联在第四项研究中并不明显(调整的相对风险:0.96;统计学上不显著),当调整社会人口统计学变量时。特别是女性和慢性肌肉骨骼疼痛疾病的风险增加。
创伤后应激障碍可以增加慢性非癌症疼痛患者中发生阿片类药物使用障碍的风险,更好地理解这种关系将有助于预测和预防阿片类药物使用障碍的发展,也可能有助于减少与慢性非癌症疼痛相关的残疾和负担。
■这篇综述量化了慢性非癌症疼痛患者在创伤后应激障碍背景下发生阿片类药物使用障碍的风险。意识和随后的实践变化将减少与慢性非癌症疼痛相关的日益增加的全球负担。
UNASSIGNED: There is emerging evidence that posttraumatic-stress disorder may have mediating effects in development of chronic-non-cancer-pain and opioid-use-disorder independently, but its impact on the development of opioid-use-disorder in people with chronic-non-cancer pain is still unclear.
UNASSIGNED: (i) Estimate the risk of opioid-use-disorder among individuals with chronic-non-cancer-pain and posttraumatic-stress disorder, relative to those with chronic-non-cancer-pain only, and (ii) identify potential correlates of opioid-use-disorder among people with chronic-non-cancer-pain and posttraumatic-stress disorder.
UNASSIGNED: This systematic
review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Longitudinal, epidemiological, cohort, follow-up, retrospective, prospective and cross-sectional studies reporting measures of variance on the likelihood of developing opioid-use-disorder with posttraumatic-stress disorder among individuals with chronic-non-cancer-pain were identified from six-electronic databases (Medline, Embase, Evidence-based Medicine reviews, PsycINFO, Scopus and Web of Science) until December 2022.
UNASSIGNED: Three out of the four studies, which met the selection criteria for this analysis reported statistically significant positive association between risk of developing opioid-use-disorder with posttraumatic-stress disorder among chronic-non-cancer-pain cohort (unadjusted Relative-Risk range: 1.51-5.27) but this association was not evident in the fourth study (adjusted Relative-Risk: 0.96; statistically non-significant), when adjusted for sociodemographic variables. The increased risk was noted particularly with females and chronic musculoskeletal pain conditions.
UNASSIGNED: Posttraumatic-stress disorder can increase the risk of development of opioid-use-disorder among people with chronic-non-cancer-pain and a better understanding of this relationship will help to predict and prevent the development of opioid-use-disorder and may also help in reducing the disability and burden associated with chronic-non-cancer-pain.
UNASSIGNED: This
review quantifies the risk of developing opioid-use-disorder in the context of posttraumatic-stress disorder among individuals with chronic-non-cancer-pain. Awareness and subsequent practice change will reduce the increasing global burden associated with the chronic-non-cancer-pain.