Fach Michèle, Bischof Gallus, Schmidt Christina, Rumpf Hans-Juergen
Research Group S:TEP (Substance Abuse: Treatment, Epidemiology and Prevention), Department of Psychiatry and Psychotherapy, Medical University of Lübeck, Lübeck, Germany.
Gen Hosp Psychiatry. 2007 May-Jun;29(3):257-63. doi: 10.1016/j.genhosppsych.2007.01.016.
The aim of this study was to determine the prevalence of dependence on prescription drugs (DPD) and associated comorbid disorders in consecutive general hospital inpatients.
The sample consisted of 952 volunteer patients (age range, 18 to 64 years) in a German general hospital. The screening instrument was a self-administered questionnaire. A personal interview containing the Structured Clinical Interview for DSM-IV (SCID, Axis I) was used to evaluate positive screening results and to diagnose comorbid disorders.
The current prevalence of DPD was 4.7% [95% confidence interval (CI), 3.40-6.18; n=45). The current prevalence of single sedative dependence was 1.4% (95% CI, 0.62-2.14); of single hypnotic dependence, 1.2% (95% CI, 0.47-1.87); and of painkillers, 1.3% (95% CI, 0.54-2.01). In addition, dependence on sedatives and hypnotics was found in 0.1% of screened patients, painkillers and sedatives in 0.2%, painkillers and hypnotics in 0.4% and all three substances in 0.2%. Women were slightly overrepresented. The average age was 50.3 years. Psychiatric Axis I comorbidities were diagnosed in 66.7% of all cases, mostly anxiety disorders, followed by comorbid substance use and affective disorders.
The results indicate that the prevalence of DPD in general hospitals is frequent and should therefore become an important subject for health care providers. The general hospital might serve as an appropriate setting to provide early interventions for this group of patients.
本研究旨在确定综合性医院连续住院患者中处方药物依赖（DPD）及相关共病障碍的患病率。
样本包括德国一家综合性医院的952名志愿患者（年龄范围18至64岁）。筛查工具为一份自行填写的问卷。采用包含《精神疾病诊断与统计手册》第四版（DSM-IV，轴I）结构化临床访谈的个人访谈来评估筛查阳性结果并诊断共病障碍。
DPD的当前患病率为4.7%[95%置信区间（CI），3.40 - 6.18；n = 45]。单一镇静剂依赖的当前患病率为1.4%（95%CI，0.62 - 2.14）；单一催眠药依赖为1.2%（95%CI，0.47 - 1.87）；止痛药依赖为1.3%（95%CI，0.54 - 2.01）。此外，0.1%的筛查患者存在镇静剂和催眠药依赖，0.2%存在止痛药和镇静剂依赖，0.4%存在止痛药和催眠药依赖，0.2%存在三种物质均依赖。女性占比略高。平均年龄为50.3岁。所有病例中66.7%被诊断为精神科轴I共病，主要是焦虑症，其次是共病物质使用障碍和情感障碍。
结果表明，综合性医院中DPD的患病率较高，因此应成为医疗服务提供者的重要关注对象。综合性医院可能是为这类患者提供早期干预的合适场所。
