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大麻依赖治疗寻求者的精神病理学及其与后期药物滥用治疗的关联。

Psychopathology among cannabis-dependent treatment seekers and association with later substance abuse treatment.

作者信息

Arendt Mikkel, Rosenberg Raben, Foldager Leslie, Perto Gurli, Munk-Jørgensen Povl

机构信息

Center for Basic Psychiatric Research, Aarhus University Hospital, DK-8240 Risskov, Denmark.

出版信息

J Subst Abuse Treat. 2007 Mar;32(2):113-9. doi: 10.1016/j.jsat.2006.07.005. Epub 2006 Oct 27.

Abstract

We determined the proportion of psychiatric treatments for disorders not due to substance use among a cohort of subjects (n = 3,114) seeking treatment for cannabis dependence. Data were retrieved from Danish treatment registers. Cases were compared with a representative sample, which was randomly selected from the general population according to age and gender (n = 15,570). Cannabis users were followed, and reentry into substance abuse treatment was used as an outcome deploying Cox regression analysis. The proportion of treatment for all psychiatric disorders was much higher among cases than among controls: schizophrenia (odds ratio [OR] = 7.9; 95% confidence interval [95% CI] = 6.1-10.2), bipolar disorders (OR = 4.9; 95% CI = 2.8-8.5), other affective disorders (OR = 7.6; 95% CI = 6.1-9.5), and personality disorders (OR = 17.3; 95% CI = 14.5-20.5). All in all, 40.7% of cases, compared with 5.2% of controls, had received psychiatric treatment (OR = 12.5; 95% CI = 11.3-13.8). A history of psychiatric treatment was associated with increased rates of reentry into substance abuse treatment, in general (OR = 1.35; 95% CI = 1.20-1.53), specifically for cannabis (OR = 1.26; 95% CI = 1.07-1.48) and opioid (OR = 1.56; 95% CI = 1.23-1.99) dependence. This is the first study to show that the proportion of psychiatric treatment is much elevated among subjects seeking treatment for cannabis dependence, and that a history of psychiatric problems is associated with higher rates of reentry into substance abuse treatment.

摘要

我们确定了一组寻求大麻依赖治疗的受试者(n = 3114)中,针对非物质使用所致精神障碍的精神治疗比例。数据取自丹麦治疗登记册。将病例与根据年龄和性别从普通人群中随机抽取的代表性样本(n = 15570)进行比较。对大麻使用者进行随访,并将再次进入药物滥用治疗作为结果,采用Cox回归分析。病例组中所有精神障碍的治疗比例远高于对照组:精神分裂症(优势比[OR]=7.9;95%置信区间[95%CI]=6.1 - 10.2)、双相情感障碍(OR = 4.9;95%CI = 2.8 - 8.5)、其他情感障碍(OR = 7.6;95%CI = 6.1 - 9.5)和人格障碍(OR = 17.3;95%CI = 14.5 - 20.5)。总体而言,40.7%的病例接受过精神治疗,而对照组为5.2%(OR = 12.5;95%CI = 11.3 - 13.8)。一般来说,有精神治疗史与再次进入药物滥用治疗的比率增加有关(OR = 1.35;95%CI = 1.20 - 1.53),特别是对于大麻(OR = 1.26;95%CI = 1.07 - 1.48)和阿片类药物(OR = 1.56;95%CI = 1.23 - 1.99)依赖。这是第一项表明寻求大麻依赖治疗的受试者中精神治疗比例大幅升高,且精神问题史与再次进入药物滥用治疗的较高比率相关的研究。

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