我们的目的是使用大型队列数据库来确定用于疼痛管理的镇痛药的使用与情绪障碍的发作和进展之间的关系。我们根据年龄、收入、健康相关变量、病史、查尔森合并症指数和镇痛药处方行为，计算了患者发生情绪障碍的风险的风险比 (HR) 和 95% 置信区间 (CI)（模型 1-3） 。此外，我们使用比例风险回归模型确定了按年龄组（模型 4）划分的情绪障碍发生风险。年龄和收入调整后的 HR（模型 1）为 1.8275。年龄、收入、BMI 和体力活动调整后的 HR（模型 2）为 1.882。完全调整后的 HR（模型 3）为 1.698。与不使用镇痛药相比，不定期使用（HR = 1.386）和定期使用（HR = 1.698）与较高的情绪障碍风险相关。在50岁以上的患者中，参加体力活动（少于五天）的患者比不参加体力活动的患者患情绪障碍的风险更低。这表明它可能有助于预防老年癌症幸存者的情绪障碍。合并症的高风险和经常使用镇痛药是发生情绪障碍的危险因素。因此，我们的结果表明，具有高合并症风险和定期使用镇痛药史的癌症幸存者应接受仔细的精神科咨询。

We aimed to determine the relationship between the use of analgesics prescribed for pain management and the onset and progression of mood disorders using a large-scale cohort database. We calculated hazard ratios (HR) with 95% confidence intervals (CI) for patient risk of developing mood disorders based on age, income, health-related variables, disease history, Charlson comorbidity index, and analgesics prescription behavior (Models 1-3). Additionally, we determined the risk of mood disorder occurrence by age group (Model 4) using a proportional hazards regression model. The age- and income-adjusted HR (Model 1) was 1.8275. The age-, income-, BMI-, and physical-activity-adjusted HR (Model 2) was 1.882. The fully adjusted HR (Model 3) was 1.698. Compared with no analgesic use, nonregular use (HR = 1.386) and regular use (HR = 1.698) was associated with a higher risk of mood disorders. Among patients older than 50 years, those who participated in physical activity (less than five days) had a lower risk of mood disorders than those who did not. This suggests that it may be useful for preventing mood disorders in older cancer survivors. A high risk of comorbidities and regular use of analgesics are risk factors for developing mood disorders. Therefore, our results suggest that cancer survivors with a high risk of comorbidities and a history of regular analgesic use should undergo careful psychiatric consultation.