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Analgesic-Seeking Behavior in Psychiatric Inpatients

Maj Dan K. Winstead, MC, USA; 1st Lt Michael Parker, MC, USA; Col Franz J. P. Willi, MC, USA

Arch Gen Psychiatry. 1977;34(12):1463-1468.

Abstract
• Although anxiety is known to enhance a patient's response to pain, the exact relationship is unclear. This problem is particularly acute among psychiatric patients where analgesics are frequently both used and abused. This study attempts to evaluate factors associated with analgesic use among these patients with the hypothesis thatanxiety, other measures of psychopathology, and ward tension would be associated with frequent analgesic use. An unselected series of psychiatric admissions during a three month period were administered the State-Trait Anxiety Inventory, MMPI, and a questionnaire dealing with prior drug use. Propoxyphene napsylate (Darvon-N) was made freely available on request from nurses who recorded details of the interaction on a prepared card. The nursing staff also recorded unusual incidents on the unit and evaluated daily the level of ward tension. The results indicate that, when made freely available to psychiatric inpatients, propoxyphene was used very conservatively and for appropriate complaints. Factors associated with drug seeking behavior are discussed in relation to other research regarding the use and abuse of analgesics.

Author Affiliations
From the Neuropsychiatric Clinic, US Army Hospital, Nuremberg, West Germany. Dr Winstead is now with the Psychiatry Service, New Orleans Veterans Administration Hospital and Tulane University School of Medicine.

Footnotes
Accepted for publication March 22, 1976.

Reprint requests to Veterans Administration Hospital, 1601 Perdido St, New Orleans, LA 70146 (Dr Winstead).

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