Pain in alcohol use disorder: Evaluating effects of childhood trauma, perceived stress, and psychological comorbidity

被引:1
作者
Schwandt, M. L. [1 ]
Ramchandani, V. A. [2 ]
Upadhyay, J. [3 ,4 ]
Ramsden, C. [5 ]
Diazgranados, N.
Goldman, D. [6 ]
机构
[1] NIAAA, Off Clin Director, Bldg 10 CRC,Room 1-5330, Bethesda, MD 20892 USA
[2] NIAAA, Human Psychopharmacol Lab, Bethesda, MD 20892 USA
[3] Harvard Med Sch, Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Boston, MA USA
[4] Harvard Med Sch, McLean Hosp, Dept Psychiat, Belmont, MA USA
[5] NIA, Lab Clin Invest, Baltimore, MD USA
[6] NIAAA, Lab Neurogenet, Rockville, MD USA
基金
美国国家卫生研究院;
关键词
Alcohol Use Disorder; Chronic Pain; Childhood Abuse; Stress; Comorbidity; PTSD; PHYSICAL PAIN; NEURAL MECHANISMS; TREATMENT-SEEKING; NEGATIVE AFFECT; SEX-DIFFERENCES; PREVALENCE; ADULTS; METAANALYSIS; ASSOCIATION; HEALTH;
D O I
10.1016/j.alcohol.2024.03.013
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
The relationship between pain and alcohol use disorder (AUD) is complex and bidirectional. The current study examines risk factors for pain in a large comprehensively phenotyped sample including individuals from across the spectrum of alcohol use and misuse. Participants (n =1101) were drawn from the National Institute on Alcohol Abuse and Alcoholism Natural History Protocol and included treatment -seeking AUD inpatients (AUD+Tx, n = 369), individuals with AUD not seeking treatment (AUD+, n = 161), and individuals without AUD (AUD-, n = 571). General linear models were utilized to test the effects of AUD status, history of childhood trauma exposure, perceived stress, and psychological comorbidity on daily percent time in pain, as well as change in daily percent time in pain across the inpatient stay in AUD+Tx individuals. Overall, 60.2% individuals reported any pain, with a signi ficantly higher prevalence in the AUD+Tx group (82.1%) compared to the AUD+ (56.5%) and AUD- (47.1%) groups. Daily percent time in pain was also highest in the AUD+Tx group (30.2%) and was further increased in those with a history of childhood abuse and comorbid posttraumatic stress disorder (PTSD). Years of heavy drinking and craving were also associated with increased percent time in pain in the AUD+Tx group. Percent time in pain decreased following acute withdrawal in the AUD+Tx group but plateaued around 25% just prior to discharge. Individuals seeking inpatient treatment for AUD, especially those with a history of childhood trauma and/or comorbid PTSD, report greater percent time in pain compared to those not seeking treatment and those without AUD. The prolonged experience of pain in abstinent AUD inpatients after the resolution of acute withdrawal may signal the early stages of protracted withdrawal. Integrative treatments targeting pain and other symptoms of protracted withdrawal may be effective in improving overall function in people with severe AUD. Published by Elsevier Inc.
引用
收藏
页码:43 / 54
页数:12
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