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Anxiety and Mood Disorders Impacting Physician Opioid Prescribing in the Pediatric Hospital Setting

Candice D Donaldson1,2, Zeev N Kain2,3, Louis Ehwerhemuepha4

  • 1Department of Psychology, Crean College of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA, 92866, USA.

Journal of Clinical Psychology in Medical Settings
|February 10, 2021
PubMed

Insights

Pediatric patients with anxiety or mood disorders experienced more pain but received fewer opioids. Physicians favored non-opioid pain relief for these children, suggesting mental health influences pain management decisions.

Area of Science:

  • Medical research
  • Clinical practice
  • Health outcomes

Background:

  • Pain management in pediatric inpatients is complex.
  • Mental health conditions may influence clinical decision-making.
  • Understanding disparities in pain treatment is crucial.

Purpose of the Study:

  • To investigate opioid prescription patterns for pediatric inpatients with and without anxiety/mood disorders.
  • To determine if mental health diagnoses affect opioid use for pain management.
  • To explore the relationship between anxiety, pain, and opioid prescribing.

Main Methods:

  • Cross-sectional analysis of electronic medical record data.
  • Propensity score matching to compare patient groups.
  • Statistical analysis of pain scores and analgesic orders.

Main Results:

  • Patients with anxiety/mood disorders reported higher pain levels but were prescribed fewer opioids.
  • Physicians were less likely to order opioids for patients with mental health conditions.
  • Anxiety diagnosis weakened the pain-opioid relationship; non-opioid analgesics were more common.

Conclusions:

  • Pediatric mental health status appears to influence pain management strategies.
  • Physicians may undertreat pain in patients with anxiety/mood disorders by limiting opioid use.
  • Further research is needed to optimize pain relief for vulnerable pediatric populations.

Keywords:
Anxiety disordersMood disordersOpioidsPain managementPediatric pain

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