Shaffer Howard J, Nelson Sarah E, LaPlante Debi A, LaBrie Richard A, Albanese Mark, Caro Gabriel
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
J Consult Clin Psychol. 2007 Oct;75(5):795-804. doi: 10.1037/0022-006X.75.5.795.
Psychiatric comorbidity likely contributes to driving under the influence (DUI) of alcohol among repeat offenders. This study presents one of the first descriptions of the prevalence and comorbidity of psychiatric disorders among repeat DUI offenders in treatment. Participants included all consenting eligible admissions (N = 729) to a 2-week inpatient treatment facility for court-sentenced repeat DUI offenders (i.e., offenders electing treatment in place of prison time) from April 17, 2005, to April 23, 2006. Participants completed the Composite International Diagnostic Interview, which assessed the following disorders using criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994): alcohol use and drug use, bipolar, generalized anxiety, posttraumatic stress, intermittent explosive, conduct, attention deficit, nicotine dependence, pathological gambling, and major depressive. Repeat DUI offenders evidenced higher lifetime and 12-month prevalence of alcohol use and drug use disorders, conduct disorder, posttraumatic stress disorder, generalized anxiety disorder, and bipolar disorder compared with the general population. Almost half qualified for lifetime diagnoses of both addiction (i.e., alcohol, drug, nicotine, and/or gambling) and a psychiatric disorder. Lifetime and past-year comorbidity rates were higher among participants than in the general population. These results suggest that clinicians should consider multimorbidity within DUI treatment protocols.
精神疾病共病可能促使屡犯者在酒精影响下驾车(DUI)。本研究首次描述了接受治疗的屡犯DUI者中精神疾病的患病率和共病情况。研究对象包括2005年4月17日至2006年4月23日期间,所有同意参与的符合条件的法庭判决屡犯DUI者(即选择接受治疗而非服刑的罪犯),他们被收治于一家为期两周的住院治疗机构(N = 729)。研究对象完成了综合国际诊断访谈,该访谈依据《精神疾病诊断与统计手册》(第4版;美国精神病学协会,1994年)的标准评估了以下疾病:酒精使用和药物使用、双相情感障碍、广泛性焦虑症、创伤后应激障碍、间歇性暴怒障碍、品行障碍、注意力缺陷多动障碍、尼古丁依赖、病态赌博和重度抑郁症。与普通人群相比,屡犯DUI者在酒精使用和药物使用障碍、品行障碍、创伤后应激障碍、广泛性焦虑症和双相情感障碍的终生患病率和12个月患病率更高。几乎一半的人符合成瘾(即酒精、药物、尼古丁和/或赌博)和精神疾病的终生诊断标准。研究对象的终生和过去一年共病率高于普通人群。这些结果表明,临床医生应在DUI治疗方案中考虑多种疾病共存的情况。