Stewart Scott H
Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston 29425, USA.
Int J Psychiatry Med. 2007;37(1):59-67. doi: 10.2190/E075-04TK-2N6J-1RH5.
Brief medical management and alcohol pharmacotherapy are effective treatments for alcoholic participants enrolled in randomized controlled trials, and this suggests that alcoholism treatment may be delivered successfully in medical settings. However, medical patients may differ from clinical trial participants in ways that suggest a need for more intensive alcoholism treatment. To explore this possibility, this study evaluated the prevalence of mental health disorders in the U.S. population stratified by alcoholism and recent hospitalization or emergency room use.
Data from the National Epidemiological Survey on Alcohol and Related Conditions were analyzed. Subjects with information on alcohol use disorders, emergency room use, hospitalization, and several mental health diagnoses were included (n = 41,961). Methods appropriate for complex survey data were used to determine the relative risk for mental health diagnoses as a function of a current alcohol use disorder and receipt of acute medical care (hospitalization or emergency room visits) within the past year.
Results showed that, relative to alcoholic adults who did not have an emergency room visit or hospitalization, alcoholic adults with use of these services had an increased prevalence of personality disorders, depression, and other drug use disorders.
Research is needed to evaluate if these and other differences will lead to poorer treatment outcomes for this group relative to the more selected populations included in medical management efficacy trials.
简短的药物治疗和酒精药物疗法对于参与随机对照试验的酗酒者来说是有效的治疗方法,这表明酒精成瘾治疗或许能在医疗环境中成功实施。然而,内科患者可能在某些方面与临床试验参与者有所不同,这表明需要更强化的酒精成瘾治疗。为探究这种可能性,本研究评估了按酒精成瘾以及近期住院或急诊就诊情况分层的美国人群中精神健康障碍的患病率。
对全国酒精及相关疾病流行病学调查的数据进行分析。纳入有酒精使用障碍、急诊就诊、住院以及多项精神健康诊断信息的受试者(n = 41,961)。采用适合复杂调查数据的方法来确定作为当前酒精使用障碍以及过去一年中接受急性医疗护理(住院或急诊就诊)函数的精神健康诊断的相对风险。
结果显示,与未进行急诊就诊或住院的酗酒成年人相比,使用这些服务的酗酒成年人患人格障碍、抑郁症和其他药物使用障碍的患病率更高。
需要开展研究来评估相对于医疗管理疗效试验中纳入的经过更严格筛选的人群,这些差异以及其他差异是否会导致该群体的治疗效果更差。