Pirard Sandrine, Sharon Estee, Kang Shimi K, Angarita Gustavo A, Gastfriend David R
Addiction Research Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 388 Commonwealth Avenue, Boston, MA 02115, USA.
Drug Alcohol Depend. 2005 Apr 4;78(1):57-64. doi: 10.1016/j.drugalcdep.2004.09.005. Epub 2004 Nov 21.
More than half of substance abusers entering addiction treatment report a history of physical or sexual abuse. It is unclear if such a history impacts treatment outcomes. This one-year follow-up study of 700 substance abusers sought to clarify the relationship between lifetime physical and/or sexual abuse and addiction treatment outcome to help address the specific needs of this population. To achieve this goal, baseline characteristics, no-show for treatment status, post-treatment clinical outcomes, and treatment history were studied for subjects with lifetime history of abuse (47.3%) versus without. Abused subjects, predominantly women, were significantly more impaired at baseline on clinical dimensions including family/social severity and psychiatric severity as measured by the Addiction Severity Index (ASI), and general level of functioning. The two groups endorsed different drugs as primary, with the abused group less frequently endorsing heroin and cocaine in favor of alcohol and polydrug use. Abused subjects reported more prior medical and psychiatric treatments. Abuse history was not a predictor of no-show for treatment. Over the 1-year follow-up, lifetime physical and/or sexual abuse was significantly associated with worse psychiatric status and more psychiatric hospitalizations and outpatient treatment despite receiving similar intensive addiction treatment.
超过半数接受成瘾治疗的药物滥用者报告有身体或性虐待史。尚不清楚这样的病史是否会影响治疗效果。这项针对700名药物滥用者的为期一年的随访研究，旨在阐明终生身体和/或性虐待与成瘾治疗效果之间的关系，以帮助满足这一人群的特殊需求。为实现这一目标，对有终生虐待史（47.3%）和无终生虐待史的受试者的基线特征、治疗失约状态、治疗后临床结果和治疗史进行了研究。受虐待的受试者，主要为女性，在包括家庭/社会严重程度和精神严重程度（通过成瘾严重程度指数（ASI）衡量）以及总体功能水平等临床维度上，基线时受损程度明显更高。两组将不同的药物列为主要药物，受虐待组较少将海洛因和可卡因列为主要药物，而更倾向于酒精和多种药物使用。受虐待的受试者报告有更多先前的医疗和精神治疗。虐待史不是治疗失约的预测因素。在1年的随访中，尽管接受了类似的强化成瘾治疗，但终生身体和/或性虐待与更差的精神状态、更多的精神病住院和门诊治疗显著相关。
