Schaar Ingela, Ojehagen Agneta
Department of Clinical Neuroscience, Division of Psychiatry, University Hospital, University of Lund, 22185 Lund, Sweden.
Soc Psychiatry Psychiatr Epidemiol. 2003 Feb;38(2):83-7. doi: 10.1007/s00127-003-0604-9.
The aim of this study was to investigate predictors of Quality of Life in a group of severely mentally ill substance abusers. These patients took part in a multi-centre study aimed at improving co-operation between psychiatric and social services in Sweden during the years 1995 to 1998.
Two hundred and eighty-eight patients, 62.4 % men, were included in the study. The criteria to enter the study were to have a diagnosis of severe mental illness and a diagnosis of substance dependence according to the DSM-III-R criteria. Quality of Life (QoL) was measured by a global assessment, Cantril's ladder (1965). Initially and after 18 months the following measurements were also used: Addiction Severity Index (ASI), Symptom Check List 90 (SCL-90) and The Clinical Rating Scale (CRS) for Alcohol Use (AUS) and Drug Use (DUS).
Initially those who were older and those who had an apartment of their own or who lived in sheltered living had a higher QoL than the others. Those belonging to the borderline personality disorder subgroup had a lower QoL than those belonging to other psychiatric diagnostic subgroups. At follow-up QoL had improved significantly. Improvement in QoL was related to improvements in physical health, legal and family problems, psychiatric symptoms and a reduction of alcohol and drug problems (ASI), global functioning (GAF) and psychological problems (SCL-90). A multiple stepwise regression analysis showed that improvement in QoL primarily was predicted by improvements in psychiatric symptoms. Number of months without alcohol and drugs were positively associated with improvement in QoL. As a whole, at follow-up the QoL is still not high.
In this group of severely mentally ill substance abusers, improvement in QoL was primarily predicted by improvements in psychiatric symptoms. Further, less alcohol and drug abuse seems to augment the subjective feeling of QoL.
本研究旨在调查一组重度精神疾病药物滥用者的生活质量预测因素。这些患者参与了一项多中心研究，该研究旨在改善1995年至1998年瑞典精神科与社会服务机构之间的合作。
288名患者纳入研究，其中男性占62.4%。纳入研究的标准是根据DSM-III-R标准诊断为重度精神疾病和药物依赖。生活质量（QoL）通过综合评估、坎特里尔阶梯量表（1965年）进行测量。最初和18个月后还使用了以下测量方法：成瘾严重程度指数（ASI）、症状自评量表90（SCL-90）以及酒精使用（AUS）和药物使用（DUS）的临床评定量表（CRS）。
最初，年龄较大、拥有自己公寓或住在庇护所的患者生活质量高于其他人。边缘型人格障碍亚组的患者生活质量低于其他精神科诊断亚组的患者。随访时生活质量有显著改善。生活质量的改善与身体健康、法律和家庭问题、精神症状的改善以及酒精和药物问题（ASI）、总体功能（GAF）和心理问题（SCL-90）的减少有关。多元逐步回归分析表明，生活质量的改善主要由精神症状的改善预测。无酒精和药物使用的月数与生活质量的改善呈正相关。总体而言，随访时生活质量仍然不高。
在这组重度精神疾病药物滥用者中，生活质量的改善主要由精神症状的改善预测。此外，较少的酒精和药物滥用似乎增强了生活质量的主观感受。
