Psychological variables potentially implicated in opioid-related mortality as observed in clinical practice.
Psychological variables potentially implicated in opioid-related mortality as observed in clinical practice.
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在临床实践中观察到，心理变量可能与阿片类药物相关的死亡率有关。
DOI：
10.1111/j.1526-4637.2011.01130.x
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Lowery,Amy
中科院分区：
文献类型：
--
作者：
Passik,StevenD;Lowery,Amy
在美国，与阿片类药物相关的死亡已成为一个公共卫生问题，意外和意外过量尤其令人不安。筛查心理风险因素是预防不依从性做法和识别可能易受阿片类药物治疗相关风险影响的患者的重要第一步。经过验证的筛查工具可以作为临床医生评估的补充工具帮助进行这一尝试。作为评估的一部分，结构化筛查是必不可少的，因为临床医生的判断并不是识别不依从性的最可靠方法。作为对正式筛查的补充，我们提出了讨论和未来可能的研究，在多年的临床实践中观察到的某些心理变量可能与药物不依从性和意外过量有关。这些变量包括灾难化、恐惧、冲动、注意力缺陷障碍、存在性痛苦和某些人格障碍。根据我们的经验，双重诊断的慢性疼痛患者可能会成为“化学copers”作为应对他们负面情绪的一种方式。对于这些患者来说，压力可能会导致意外过量。行为，认知行为（接受和承诺，辩证行为），存在主义（以意义为中心，尊严）和精神疗法在治疗这些高风险合并症方面是有效的，而管理疼痛缓解的预期似乎是预防意外过量的关键。
Opioid‐related deaths in the United States have become a public health problem, with accidental and unintended overdoses being especially troubling. Screening for psychological risk factors is an important first step in safeguarding against nonadherence practices and identifying patients who may be vulnerable to the risks associated with opioid therapy. Validated screening instruments can aid in this attempt as a complementary tool to clinicians' assessments. A structured screening is imperative as part of an assessment, as clinician judgment is not the most reliable method of identifying nonadherence. As a complement to formal screening, we present for discussion and possible future study certain psychological variables observed during years of clinical practice that may be linked to medication nonadherence and accidental overdose. These variables include catastrophizing, fear, impulsivity, attention deficit disorders, existential distress, and certain personality disorders. In our experience, chronic pain patients with dual diagnoses may become “chemical copers” as a way of coping with their negative emotion. For these patients, times of stress could lead to accidental overdose. Behavioral, cognitive‐behavioral (acceptance and commitment, dialectical behavior), existential (meaning‐centered, dignity), and psychotropic therapies have been effective in treating these high‐risk comorbidities, while managing expectations of pain relief appears key to preventing accidental overdose.
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DOI：
10.1016/j.jpain.2008.10.008
发表时间：
2009-02
期刊：
The journal of pain
影响因子：
--
作者：
Chou R;Fanciullo GJ;Fine PG;Adler JA;Ballantyne JC;Davies P;Donovan MI;Fishbain DA;Foley KM;Fudin J;Gilson AM;Kelter A;Mauskop A;O'Connor PG;Passik SD;Pasternak GW;Portenoy RK;Rich BA;Roberts RG;Todd KH;Miaskowski C;American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
通讯作者：
American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
有或没有药物滥用问题的女性边缘患者的创伤、解离和创伤后应激障碍
DOI：
10.1046/j.1440-1614.2003.01199.x
发表时间：
2003
影响因子：
4.6
作者：
L. M. van den Bosch;R. Verheul;W. Langeland;W. van den Brink
通讯作者：
W. van den Brink
影响因子：
4.2
作者：
Wilsey, B. L.;Fishman, S. M.;Li, C. S.
通讯作者：
Li, C. S.
我们正在培训未来的疼痛专家吗？
影响因子：
2.6
作者：
J. Livengood;Benjamin W. Johnson
通讯作者：
Benjamin W. Johnson
对比情绪方法应对慢性肌筋膜疼痛的被动应对
影响因子：
3.8
作者：
Julie;M. Lumley;D. Longo
通讯作者：
D. Longo