Baethge Christopher, Baldessarini Ross J, Khalsa Hari-Mandir Kaur, Hennen John, Salvatore Paola, Tohen Mauricio
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Am J Psychiatry. 2005 May;162(5):1008-10. doi: 10.1176/appi.ajp.162.5.1008.
This study clarified the early characteristics of substance use disorders in patients with first-episode bipolar I disorder.
The authors evaluated substance use disorders, associated factors, and clinical course, prospectively, in the first 2 years of DSM-IV bipolar I disorder with standardized methods.
Baseline substance use disorder was found in 33% (37 of 112) of the patients at baseline and in 39% at 24 months. Anxiety disorders were more frequent in the patients with than without substance use disorder (30% and 13%, respectively). Associations of alcohol dependence with depressive symptoms and cannabis dependence with manic symptoms were suggested. Patients using two or more substances had worse outcomes.
Since substance use disorders were frequent from the beginning of bipolar I disorder and were associated with anxiety disorders and poor outcome, early interventions for substance use disorder and anxiety might improve later outcome.
本研究阐明了首发双相I型障碍患者物质使用障碍的早期特征。
作者采用标准化方法，对首次发作的DSM-IV双相I型障碍患者的前两年进行前瞻性评估，包括物质使用障碍、相关因素及临床病程。
基线时，112名患者中有33%（37名）存在物质使用障碍，24个月时这一比例为39%。有物质使用障碍的患者比无该障碍的患者更常出现焦虑障碍（分别为30%和13%）。提示酒精依赖与抑郁症状、大麻依赖与躁狂症状之间存在关联。使用两种或更多物质的患者预后更差。
由于物质使用障碍在双相I型障碍起病之初就很常见，且与焦虑障碍及不良预后相关，因此对物质使用障碍和焦虑进行早期干预可能会改善后期预后。
Zotero 插件