Poser W, Poser S, Eva-Condemarin P
Psychiatrische und Neurologische Universitätskliniken Göttingen (Unit for Addiction Research), Germany.
Drug Alcohol Depend. 1992 Apr;30(1):49-57. doi: 10.1016/0376-8716(92)90035-b.
In 1974 we started a follow-up of patients with different psychoactive substance use disorders (PSUD) according to DSM-III; 2082 cases out of 2127 were analyzed; 1370 patients had taken legal drugs (i.e. prescription drugs and/or over-the-counter drugs); 444 patients suffered from abuse or dependence of legal drugs alone; 678 combined legal drugs and ethanol, and 248 cases combined legal and illegal drugs, often together with ethanol. A group of 712 alcoholics were included for comparison. Mean time under observation was 6.5 +/- 5.4 years, and 269 patients died. Mortality and survival were calculated and compared with expected survival from the normal population of the former Federal Republic of Germany. Mortality in all subgroups of PSUD was increased, the standardized mortality ratio (SMR) for patients on legal drugs alone being 2.1. Patients with legal plus illegal drugs had a SMR as high as 20.7; those with legal drugs plus ethanol 3.4; and alcoholics 4.2. The increased mortality seemed to be constant over the years. Mortality decreased in patients with stable abstinence. There was no clear sex difference. Abuse had a better prognosis than dependence. An estimation of potential life lost by the different PSUDs was attempted. Patients on legal drugs died from suicides, malignancies or accidents (including intoxication). In alcoholics or patients on legal drugs plus ethanol malignoma, liver cirrhosis, accident and suicide were the most prominent causes of death.
1974年，我们开始对符合《精神疾病诊断与统计手册》第三版（DSM-III）标准的不同精神活性物质使用障碍（PSUD）患者进行随访；对2127例患者中的2082例进行了分析；1370例患者使用过合法药物（即处方药和/或非处方药）；444例患者仅存在合法药物滥用或依赖问题；678例患者同时使用合法药物和乙醇，248例患者同时使用合法和非法药物，且常常同时伴有乙醇使用。纳入了一组712例酗酒者作为对照。平均观察时间为6.5±5.4年，有269例患者死亡。计算了死亡率和生存率，并与前德意志联邦共和国正常人群的预期生存率进行了比较。所有PSUD亚组的死亡率均升高，仅使用合法药物的患者标准化死亡率比（SMR）为2.1。同时使用合法和非法药物的患者SMR高达20.7；使用合法药物加乙醇的患者为3.4；酗酒者为4.2。多年来，死亡率升高似乎保持稳定。持续戒酒的患者死亡率降低。未发现明显的性别差异。滥用的预后比依赖更好。尝试估算了不同PSUD导致的潜在生命损失。使用合法药物的患者死于自杀、恶性肿瘤或事故（包括中毒）。酗酒者或使用合法药物加乙醇的患者中，恶性肿瘤、肝硬化、事故和自杀是最主要的死亡原因。
