Gossop Michael, Marsden John, Stewart Duncan
National Addiction Centre, Institute of Psychiatry/Maudsley Hospital, Kings College London, UK.
J Nerv Ment Dis. 2006 Nov;194(11):826-32. doi: 10.1097/01.nmd.0000244483.17443.0e.
The study investigates changes in psychiatric symptoms after drug dependence treatment, and relationships between pretreatment problems, illicit drug use, treatment retention, and changes in psychiatric symptoms. The sample comprised 662 drug-dependent adults recruited at admission to treatment in residential rehabilitation programs (15 agencies) or outpatient methadone treatment (16 methadone maintenance programs and 15 methadone reduction programs). Using a longitudinal, prospective cohort design, data were collected by structured interviews at intake to treatment and at 1-month and 6-month follow-ups. Reductions were found in a range of psychiatric symptoms after admission to drug dependence treatment and among patients treated in outpatient and in residential programs. These reductions occurred rapidly (during the first month) and were maintained at subsequent follow-up. At intake to treatment, 39% of the residential sample met criteria for psychiatric caseness. This figure dropped to 3% at both 1-month and 6-month follow-up. Among methadone patients, 15% met criteria for psychiatric caseness at intake, and this dropped to 5% at 1 month and 3% at 6 months. Improvement in psychiatric symptoms was positively related to treatment retention. Some of the psychiatric symptoms presented by drug-dependent patients at admission to treatment are associated with drug misuse and show rapid remission after substance misuse treatment.
该研究调查了药物依赖治疗后精神症状的变化,以及治疗前问题、非法药物使用、治疗保留率与精神症状变化之间的关系。样本包括662名药物依赖成年人,他们是在住院康复项目(15个机构)或门诊美沙酮治疗(16个美沙酮维持项目和15个美沙酮减量项目)入院时招募的。采用纵向前瞻性队列设计,在治疗开始时以及1个月和6个月随访时通过结构化访谈收集数据。在药物依赖治疗入院后以及门诊和住院项目治疗的患者中,一系列精神症状都有所减轻。这些减轻在治疗后的第一个月内迅速出现,并在随后的随访中得以维持。在治疗开始时,39%的住院样本符合精神疾病诊断标准。这一数字在1个月和6个月随访时降至3%。在美沙酮治疗患者中,15%在治疗开始时符合精神疾病诊断标准,在1个月时降至5%,在6个月时降至3%。精神症状的改善与治疗保留率呈正相关。药物依赖患者在治疗入院时出现的一些精神症状与药物滥用有关,并且在药物滥用治疗后迅速缓解。