Alcohol and Drug Abuse Treatment Program, McLean Hospital, Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA.
Psychiatr Clin North Am. 2010 Jun;33(2):339-55. doi: 10.1016/j.psc.2010.01.004.
Gender differences in substance use disorders (SUDs) and treatment outcomes for women with SUDs have been a focus of research in the last 15 years. This article reviews gender differences in the epidemiology of SUDs, highlighting the convergence of male/female prevalence ratios of SUDs in the last 20 years. The telescoping course of SUDs, recent research on the role of neuroactive gonadal steroid hormones in craving and relapse, and sex differences in stress reactivity and relapse to substance abuse are described. The role of co-occurring mood and anxiety, eating, and posttraumatic stress disorders is considered in the epidemiology, natural history, and treatment of women with SUDs. Women's use of alcohol, stimulants, opioids, cannabis, and nicotine are examined in terms of recent epidemiology, biologic and psychosocial effects, and treatment. Although women may be less likely to enter substance abuse treatment than men over the course of the lifetime, once they enter treatment, gender itself is not a predictor of treatment retention, completion, or outcome. Research on gender-specific treatments for women with SUDs and behavioral couples treatment has yielded promising results for substance abuse treatment outcomes in women.
在过去的 15 年中，性别差异在物质使用障碍（SUD）及其女性 SUD 治疗结果方面一直是研究的重点。本文综述了 SUD 流行病学中的性别差异，强调了过去 20 年中 SUD 的男性/女性患病率比值的趋同。描述了 SUD 的进展过程、神经活性性腺类固醇激素在渴望和复发中的作用的最新研究，以及应激反应和物质滥用复发方面的性别差异。在 SUD 女性的流行病学、自然史和治疗中考虑了共病心境和焦虑、饮食和创伤后应激障碍的作用。从最近的流行病学、生物学和心理社会影响以及治疗的角度考察了女性对酒精、兴奋剂、阿片类药物、大麻和尼古丁的使用。尽管女性在一生中进入物质滥用治疗的可能性可能低于男性，但一旦进入治疗，性别本身并不是治疗保留、完成或结果的预测因素。针对女性 SUD 患者的特定性别治疗和行为夫妻治疗的研究为女性物质滥用治疗结果带来了有希望的结果。
