Psychosocial factors predict opioid analgesia through endogenous opioid function.
Identifieur interne : 000C74 ( Main/Corpus ); précédent : 000C73; suivant : 000C75Psychosocial factors predict opioid analgesia through endogenous opioid function.
Auteurs : John W. Burns ; Stephen Bruehl ; Christopher R. France ; Erik Schuster ; Daria Orlowska ; Asokumar Buvanendran ; Melissa Chont ; Rajnish K. GuptaSource :
- Pain [ 1872-6623 ] ; 2017.
English descriptors
- KwdEn :
- Administration, Intravenous (MeSH), Adult (MeSH), Analgesics, Opioid (administration & dosage), Catastrophization (chemically induced), Catastrophization (psychology), Chronic Pain (drug therapy), Chronic Pain (psychology), Cross-Over Studies (MeSH), Double-Blind Method (MeSH), Female (MeSH), Humans (MeSH), Low Back Pain (drug therapy), Low Back Pain (psychology), Male (MeSH), Middle Aged (MeSH), Mood Disorders (chemically induced), Morphine (administration & dosage), Naloxone (administration & dosage), Narcotic Antagonists (administration & dosage), Pain Measurement (MeSH), Pain Threshold (drug effects), Pain Threshold (physiology), Psychiatric Status Rating Scales (MeSH), Self Report (MeSH).
- MESH :
- chemical , administration & dosage : Analgesics, Opioid, Morphine, Naloxone, Narcotic Antagonists.
- chemically induced : Catastrophization, Mood Disorders.
- drug effects : Pain Threshold.
- drug therapy : Chronic Pain, Low Back Pain.
- physiology : Pain Threshold.
- psychology : Catastrophization, Chronic Pain, Low Back Pain.
- Administration, Intravenous, Adult, Cross-Over Studies, Double-Blind Method, Female, Humans, Male, Middle Aged, Pain Measurement, Psychiatric Status Rating Scales, Self Report.
Abstract
Use of opioid analgesics for management of chronic nonmalignant pain has become common, yet there are presently no well-validated predictors of optimal opioid analgesic efficacy. We examined whether psychosocial factors (eg, depressive symptoms) predicted changes in spontaneous low back pain after administration of opioid analgesics, and whether endogenous opioid (EO) function mediated these relationships. Participants with chronic low back pain but who were not chronic opioid users (N = 89) underwent assessment of low back pain intensity pre- and post-drug in 3 (counterbalanced) conditions: (1) placebo, (2) intravenous naloxone, and (3) intravenous morphine. Comparison of placebo condition changes in back pain intensity to those under naloxone and morphine provided indexes of EO function and opioid analgesic responses, respectively. Results showed that (1) most psychosocial variables were related significantly and positively to morphine analgesic responses for low back pain, (2) depressive symptoms, trait anxiety, pain catastrophizing, and pain disability were related negatively to EO function, and (3) EO function was related negatively to morphine analgesic responses for low back pain. Bootstrapped mediation analyses showed that links between morphine analgesic responses and depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability were partially mediated by EO function. Results suggest that psychosocial factors predict elevated analgesic responses to opioid-based medications, and may serve as markers to identify individuals who benefit most from opioid therapy. Results also suggest that people with greater depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability may have deficits in EO function, which may predict enhanced response to opioid analgesics.
DOI: 10.1097/j.pain.0000000000000768
PubMed: 27898491
PubMed Central: PMC7176103
Links to Exploration step
pubmed:27898491Le document en format XML
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<term>Catastrophization (psychology)</term>
<term>Chronic Pain (drug therapy)</term>
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<front><div type="abstract" xml:lang="en">Use of opioid analgesics for management of chronic nonmalignant pain has become common, yet there are presently no well-validated predictors of optimal opioid analgesic efficacy. We examined whether psychosocial factors (eg, depressive symptoms) predicted changes in spontaneous low back pain after administration of opioid analgesics, and whether endogenous opioid (EO) function mediated these relationships. Participants with chronic low back pain but who were not chronic opioid users (N = 89) underwent assessment of low back pain intensity pre- and post-drug in 3 (counterbalanced) conditions: (1) placebo, (2) intravenous naloxone, and (3) intravenous morphine. Comparison of placebo condition changes in back pain intensity to those under naloxone and morphine provided indexes of EO function and opioid analgesic responses, respectively. Results showed that (1) most psychosocial variables were related significantly and positively to morphine analgesic responses for low back pain, (2) depressive symptoms, trait anxiety, pain catastrophizing, and pain disability were related negatively to EO function, and (3) EO function was related negatively to morphine analgesic responses for low back pain. Bootstrapped mediation analyses showed that links between morphine analgesic responses and depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability were partially mediated by EO function. Results suggest that psychosocial factors predict elevated analgesic responses to opioid-based medications, and may serve as markers to identify individuals who benefit most from opioid therapy. Results also suggest that people with greater depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability may have deficits in EO function, which may predict enhanced response to opioid analgesics.</div>
</front>
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<Abstract><AbstractText>Use of opioid analgesics for management of chronic nonmalignant pain has become common, yet there are presently no well-validated predictors of optimal opioid analgesic efficacy. We examined whether psychosocial factors (eg, depressive symptoms) predicted changes in spontaneous low back pain after administration of opioid analgesics, and whether endogenous opioid (EO) function mediated these relationships. Participants with chronic low back pain but who were not chronic opioid users (N = 89) underwent assessment of low back pain intensity pre- and post-drug in 3 (counterbalanced) conditions: (1) placebo, (2) intravenous naloxone, and (3) intravenous morphine. Comparison of placebo condition changes in back pain intensity to those under naloxone and morphine provided indexes of EO function and opioid analgesic responses, respectively. Results showed that (1) most psychosocial variables were related significantly and positively to morphine analgesic responses for low back pain, (2) depressive symptoms, trait anxiety, pain catastrophizing, and pain disability were related negatively to EO function, and (3) EO function was related negatively to morphine analgesic responses for low back pain. Bootstrapped mediation analyses showed that links between morphine analgesic responses and depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability were partially mediated by EO function. Results suggest that psychosocial factors predict elevated analgesic responses to opioid-based medications, and may serve as markers to identify individuals who benefit most from opioid therapy. Results also suggest that people with greater depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability may have deficits in EO function, which may predict enhanced response to opioid analgesics.</AbstractText>
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