Compton Wilson M, Cottler Linda B, Jacobs Jacqueline L, Ben-Abdallah Arbi, Spitznagel Edward L
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Am J Psychiatry. 2003 May;160(5):890-5. doi: 10.1176/appi.ajp.160.5.890.
Previous research has demonstrated that psychiatric disorders are common among people who abuse alcohol and drugs, but few studies have examined the relationship of psychiatric disorders to drug treatment outcome. The authors conducted such an examination.
They successfully reinterviewed 401 drug-dependent subjects (94% of the baseline in-treatment sample) and determined their drug abuse status at follow-up 12 months later.
Analyses indicated that several baseline psychiatric disorders predicted worse outcomes at follow-up. Major depression predicted using a larger number of substances and having more drug dependence diagnoses and symptoms. Alcohol dependence predicted more dependence diagnoses, antisocial personality disorder predicted using a larger number of substances, and generalized anxiety disorder predicted having more dependence diagnoses. Outcomes among men were more closely associated with psychiatric status than outcomes among women, except for phobias, which predicted a better outcome among women.
These results are unique in their assessment of individuals dependent on illicit substances. Overall, the authors found that women with phobias had better outcomes and that men with psychiatric disorders in general, men with major depression, and men with antisocial personality disorder had worse outcomes.
先前的研究表明,精神疾病在酗酒和吸毒人群中很常见,但很少有研究探讨精神疾病与药物治疗结果之间的关系。作者进行了这样一项研究。
他们成功地对401名药物依赖受试者(占基线治疗期样本的94%)进行了再次访谈,并在12个月后的随访中确定了他们的药物滥用状况。
分析表明,几种基线精神疾病预示着随访时的预后较差。重度抑郁症预示着使用更多种类的物质以及有更多的药物依赖诊断和症状。酒精依赖预示着更多的依赖诊断,反社会人格障碍预示着使用更多种类的物质,广泛性焦虑障碍预示着有更多的依赖诊断。男性的治疗结果与精神状态的关联比女性更为紧密,不过恐惧症是个例外,它预示着女性有更好的治疗结果。
这些结果在对非法药物依赖个体的评估中是独一无二的。总体而言,作者发现患有恐惧症的女性治疗结果更好,而一般患有精神疾病的男性、患有重度抑郁症的男性以及患有反社会人格障碍的男性治疗结果更差。