Sex differences among opioid-abusing patients with chronic pain in a clinical trial.
Sex differences among opioid-abusing patients with chronic pain in a clinical trial.
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DOI：
10.1097/adm.0000000000000086
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发表时间：
2015-01
影响因子：
5.5
通讯作者：
Sullivan M
中科院分区：
文献类型：
--
作者：
Manubay J;Davidson J;Vosburg S;Jones J;Comer S;Sullivan M
慢性疼痛和处方阿片类药物滥用并存的患者的特征尚未得到很好的描述，对于该人群中男性和女性之间的差异知之甚少。本研究评估了慢性疼痛和阿片类药物滥用患者在人口统计学、诊断和行为属性方面的性别差异。通过自我报告和半结构化临床访谈收集数据，来自162名患者（120名男性，42名女性），他们筛选了一项研究，调查处方阿片类药物的滥用倾向。男性和女性在年龄、种族、教育、婚姻状况或就业状况方面没有差异。参与者使用处方阿片类药物5.4 ± 6.7年。大多数参与者（60%）除了患有精神疾病诊断和统计手册IV（DSM-IV）定义的阿片类药物依赖外，还患有腰痛。更多的女性比男性报告更多的关节炎疼痛，但除此之外，疼痛类型没有差异。疼痛对女性的情绪、行走能力和社会关系产生了更大的影响。男性报告了更多的某些异常行为，包括滥用酒精或非法药物，未经授权的剂量增加，接触街头文化，以及被警察逮捕。女性比男性更抑郁。在临床试验中接受治疗的阿片类药物滥用慢性疼痛患者的人口统计学特征在性别之间相似;然而，观察到一些重要差异。妇女报告更多的精神病合并症，并赞同更大的疼痛相关的身体和社会损害。男性报告了更多的异常行为。这些差异表明，患有慢性疼痛和阿片类药物滥用/依赖的男性可能会受益于对异常行为的密切监测，而女性可能会受益于对疼痛的生理和心理影响的密切关注。
The characteristics of patients with co-occurring chronic pain and prescription opioid abuse have not been well described, and even less is known about differences between men and women in this population. This study evaluated sex differences in the demographic, diagnostic, and behavioral attributes of patients with chronic pain and opioid abuse. Data were collected via self-report and semi-structured clinical interviews from 162 patients (120 M, 42 W) who screened for a study investigating the abuse liability of prescription opioids. There were no differences between males and females in age, race, education, marital status or employment status. Participants had used prescription opioids for 5.4 ± 6.7 years. The majority of participants (60%) had low back pain in addition to opioid dependence as defined by the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). More women reported more arthritic pain than men, but otherwise there were no differences in types of pain. Pain exerted a greater effect in women on mood, walking ability, and social relations. Men reported more of certain aberrant behaviors including abuse of alcohol or illicit drugs, unauthorized dose increases, contact with street culture, and being arrested by police. Women were more depressed than men. The demographic profile of opioid-abusing chronic pain patients presenting for treatment in a clinical trial was similar between sexes; however, some important differences were observed. Women reported more psychiatric co-morbidity and endorsed greater pain-related physical and social impairment. Men reported more aberrant behaviors. These differences suggest that men with chronic pain and opioid abuse/dependence may benefit by closer monitoring of aberrant behaviors while women may benefit from closer attention paid to physical and psychological effects of pain.