Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India.
Indian J Med Res. 2009 Dec;130(6):702-8.
BACKGROUND & OBJECTIVE: Relapse is a common and distressing aspect of substance dependence mediated by several biological and psychosocial factors. This study examined the association between demographic variables, clinical parameters and certain psychosocial factors and relapse among patients with either alcohol or opioid dependence.
Structured assessments of clinical/demographic parameters, relapse precipitants, coping strategies, self-efficacy, stressful life events and perceived social support were carried out among patients with alcohol/opoid dependence (n=30) who had relapsed and compared with those (n=30) who had managed to remain abstinent. Similar comparisons were also carried out between relapsed and abstinent patients in the individual subgroups of alcohol and opioid dependence.
Patients who had relapsed were significantly more likely (i) to have a positive family history of substance use and higher number of previous relapses; (ii) to be using maladaptive coping strategies; (iii) to have been exposed to a higher total number of 'high risk' situations; and (iv) have experienced a higher number of undesirable life events. Those who had remained abstinent tended to use significantly more number of coping strategies, principally adaptive ones and scored significantly higher on all measures of self-efficacy. Factors influencing relapse appeared to be largely similar among patients with alcohol and opioid dependence.
INTERPRETATION & CONCLUSION: This study provided further evidence in support of the importance of certain clinical/psychosocial factors in relapse in substance dependence. It extended these results to substances other than alcohol and provides the basis for investigating correlates of relapse in a wide range of behavioural and substance use problems.
复发是物质依赖的一个常见且令人痛苦的方面，由多种生物和心理社会因素介导。本研究考察了人口统计学变量、临床参数和某些心理社会因素与酒精或阿片类物质依赖患者复发之间的关系。
对酒精/阿片类物质依赖患者（n=30）进行了临床/人口统计学参数、复发诱因、应对策略、自我效能、生活压力事件和感知社会支持的结构化评估，将复发患者与成功保持戒断的患者（n=30）进行了比较。还对酒精和阿片类物质依赖的个别亚组中复发和戒断患者进行了类似的比较。
复发患者更有可能（i）有物质使用的阳性家族史和更多的既往复发；（ii）使用适应不良的应对策略；（iii）接触到更高数量的“高风险”情况；和（iv）经历了更多的不良生活事件。保持戒断的患者往往使用更多数量的应对策略，主要是适应性策略，并且在所有自我效能测量中得分显著更高。影响复发的因素在酒精和阿片类物质依赖患者中似乎基本相似。
本研究进一步证明了某些临床/心理社会因素在物质依赖复发中的重要性。它将这些结果扩展到除酒精以外的物质，并为研究广泛的行为和物质使用问题的复发相关性提供了基础。
