Ilgen Mark A, Tiet Quyen, Moos Rudolf
Center for Health Care Evaluation, Department of Veterans Affairs Palo Alto Health Care System, California, USA.
J Stud Alcohol. 2004 Sep;65(5):643-50. doi: 10.15288/jsa.2004.65.643.
Numerous studies report high rates of substance-related problems and psychopathology in substance use disorder (SUD) patients with a history of a suicide attempt. However, little is known about the response of suicidal SUD patients to treatment. This study examined the treatment outcomes of suicidal and nonsuicidal SUD patients who were followed for 5 years.
A total of 2099 male SUD patients were recruited from 15 Department of Veterans Affairs residential alcohol and drug treatment programs and were assessed at four points (treatment entry, discharge, and 1 and 5 years later). Approximately 7% (n = 156) of the patients reported a suicide attempt in the 3 months prior to the start of treatment.
Although patients with a recent suicide attempt reported severe patterns of alcohol use and elevated psychiatric symptoms at baseline, they showed significant improvements in both of these domains at discharge from residential treatment, and these improvements were still evident at 1-year and 5-year follow-ups. Suicidal SUD patients were no more likely to leave treatment early than were nonsuicidal patients, and they received slightly longer and more individualized treatment.
Despite a more severe pattern of alcohol use and psychiatric symptoms at baseline, suicidal SUD patients benefitted substantially from residential SUD treatment. These findings imply that suicidal SUD patients can be treated effectively within SUD treatment settings.
众多研究报告称,有自杀未遂史的物质使用障碍(SUD)患者中,与物质相关问题和精神病理学的发生率很高。然而,对于有自杀倾向的SUD患者对治疗的反应却知之甚少。本研究调查了随访5年的有自杀倾向和无自杀倾向的SUD患者的治疗结果。
从15个退伍军人事务部的酒精和药物住院治疗项目中招募了总共2099名男性SUD患者,并在四个时间点(治疗开始时、出院时以及1年和5年后)进行评估。约7%(n = 156) 的患者报告在治疗开始前3个月内有过自杀未遂行为。
尽管近期有自杀未遂行为的患者在基线时报告有严重的饮酒模式和精神症状加重,但他们在住院治疗出院时这两个方面均有显著改善,且这些改善在1年和5年随访时仍然明显可见.有自杀倾向的SUD患者比无自杀倾向的患者更早离开治疗机构可能性更小,并且他们接受的治疗时间略长且更具个性化。
尽管基线时饮酒模式和精神症状更为严重,但有自杀倾向的SUD患者从住院SUD治疗中获益显著。这些发现表明,有自杀倾向 的SUD患者可以在SUD治疗环境中得到有效治疗。