Eggleston A Meade, Calhoun Patrick S, Svikis Dace S, Tuten Michelle, Chisolm Margaret S, Jones Hendree E
VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, Durham, NC 27705, USA.
Compr Psychiatry. 2009 Sep-Oct;50(5):415-23. doi: 10.1016/j.comppsych.2008.11.004. Epub 2009 Jan 16.
Posttraumatic stress disorder (PTSD) and other Axis I comorbidity among women with substance use disorders (SUDs) appear similarly prevalent and are associated with comparable negative clinical profiles and treatment outcomes. The relative contribution of comorbid PTSD vs other Axis I psychiatric disorders to clinical characteristics is largely unexamined, however, despite theory and empirical data indicating that PTSD and SUDs may have a unique relationship that confers specific risk for clinical severity and poor treatment outcome. In a sample of pregnant, opioid- and/or cocaine-dependent women entering substance abuse treatment, women with PTSD (SUD-PTSD; n = 23) were compared to those with other Axis I comorbidity (SUD-PSY; n = 45) and those without Axis I comorbidity (SUD-only; n = 37). Data were collected via face-to-face interviews and urinalysis drug assays. Although the study groups had similar substance use severity, the SUD-PTSD group was more likely to report suicidality, aggression, and psychosocial impairment than both the SUD-PSY and SUD-only groups. Findings indicate treatment considerations for substance-dependent women with PTSD are broader and more severe than those with other Axis I conditions or substance dependence alone.
创伤后应激障碍（PTSD）以及物质使用障碍（SUDs）女性患者中的其他轴I共病情况，其患病率似乎相近，并且与类似的负面临床特征及治疗结果相关。然而，尽管理论和实证数据表明PTSD与SUDs之间可能存在一种独特的关系，这种关系会给临床严重程度和不良治疗结果带来特定风险，但共病PTSD与其他轴I精神障碍对临床特征的相对影响在很大程度上尚未得到研究。在一组进入药物滥用治疗的怀孕、对阿片类药物和/或可卡因依赖的女性样本中，将患有PTSD的女性（SUD-PTSD；n = 23）与患有其他轴I共病的女性（SUD-PSY；n = 45）以及没有轴I共病的女性（仅SUD；n = 37）进行了比较。数据通过面对面访谈和尿液药物分析收集。尽管各研究组的物质使用严重程度相似，但SUD-PTSD组比SUD-PSY组和仅SUD组更有可能报告有自杀倾向、攻击性和社会心理障碍。研究结果表明，对于患有PTSD的物质依赖女性，治疗方面的考虑比患有其他轴I疾病或仅患有物质依赖的女性更为广泛和严重。
