前存在的精神病风险因素以及任何和长期的阿片类药物使用在头部和部癌症中
Nosayaba Osazuwa-Peters1,2,3,4,5, May Z Gao6, Russel R Kahmke1,3
1Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina.
JAMA otolaryngology-- head & neck surgery
|September 4, 2025
概括
患有抑郁症和尼古丁依赖等精神疾病增加了头癌患者处方阿片类药物的风险. 早期查可以指导更安全的阿片类药物处方做法.
科学领域:
- 癌症学
- 精神病学
- 药理学
背景情况:
- 头部和部癌症 (HNC) 与严重的精神疾病有关.
- 在癌症治疗中使用阿片类药物很常见,但与HNC的精神因素的联系尚不清楚.
研究的目的:
- 研究先前存在的精神病风险因素与HNC患者处方阿片类药物使用之间的关联.
- 确定这些因素是否预测任何阿片类药物处方或长期阿片类药物治疗 (LTOT).
主要方法:
- 使用电子健康记录进行的回顾性纵向队列研究 (Optum数据库,2010-2018).
- 包括没有先前使用阿片类药物的成年HNC患者,分析了2年的回顾数据.
- 多变量逻辑回归评估了精神因素之间的关联 (抑郁症,尼古丁依赖等) 和阿片类药物使用 (在HNC诊断后12个月内任何处方或LTOT).
主要成果:
- 在11,335名符合条件的HNC患者中,有23. 4%的患者接受了阿片类药物处方,4. 9%的患者在12个月内接受了LTOT.
- 抑郁症 (aOR,1. 21),尼古丁依赖 (aOR,1. 56) 和类药物使用 (aOR,1. 44) 与任何阿片类药物处方的更高概率有关.
- 尼古丁依赖 (aOR,1. 77) 是唯一与LTOT增加的精神因素.
结论:
- 预先存在的精神疾病,特别是抑郁症和尼古丁依赖,与HNC患者的阿片类药物处方和LTOT增加有关.
- 这些疾病的查对于明智的临床决策和更安全的阿片类药物处方在HNC管理中至关重要.
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