New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA.
Addiction. 2011 Mar;106(3):657-69. doi: 10.1111/j.1360-0443.2010.03194.x. Epub 2010 Nov 16.
To estimate the general and racial/ethnic specific cumulative probability of remission from nicotine alcohol cannabis or cocaine dependence, and to identify predictors of remission across substances.
Data were collected from structured diagnostic interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version.
The 2001-2002 National Epidemiological Survey of Alcohol and Related Conditions (NESARC) surveyed a nationally representative sample from US adults (n = 43,093) selected in a three-stage sampling design.
The subsamples of individuals with life-time DSM-IV diagnosis of dependence on nicotine (n = 6937), alcohol (n = 4781), cannabis (n = 530) and cocaine (n = 408).
Cumulative probability estimates of dependence remission for the general population and across racial/ethnic groups. Hazard ratios for remission from dependence.
Life-time cumulative probability estimates of dependence remission were 83.7% for nicotine, 90.6% for alcohol, 97.2% for cannabis and 99.2% for cocaine. Half of the cases of nicotine, alcohol, cannabis and cocaine dependence remitted approximately 26, 14, 6 and 5 years after dependence onset, respectively. Males, Blacks and individuals with diagnosis of personality disorders and history of substance use comorbidity exhibited lower hazards of remission for at least two substances.
A significant proportion of individuals with dependence on nicotine, alcohol, cannabis or cocaine achieve remission at some point in their life-time, although the probability and time to remission varies by substance and racial/ethnic group. Several predictors of remission are shared by at least two substances, suggesting that the processes of remission overlap. The lower rates of remission of individuals with comorbid personality or substance use disorders highlight the need for providing coordinated psychiatric and substance abuse interventions.
估计尼古丁、酒精、大麻或可卡因依赖症总体和种族/民族特异性缓解的累积概率，并确定跨物质缓解的预测因素。
数据来自使用酒精使用障碍和相关障碍访谈表-DSM-IV 版本进行的结构化诊断访谈。
2001-2002 年全国酒精和相关条件流行病学调查 (NESARC) 对美国成年人（n=43093）进行了全国代表性样本调查，采用三阶段抽样设计选择。
一生中 DSM-IV 诊断为尼古丁依赖（n=6937）、酒精依赖（n=4781）、大麻依赖（n=530）和可卡因依赖（n=408）的个体的亚样本。
总体人群和跨种族/民族群体的依赖缓解累积概率估计。缓解依赖的风险比。
依赖缓解的终生累积概率估计值分别为尼古丁 83.7%、酒精 90.6%、大麻 97.2%和可卡因 99.2%。尼古丁、酒精、大麻和可卡因依赖症的病例中，大约有一半在依赖症发作后 26、14、6 和 5 年分别缓解。男性、黑人以及诊断为人格障碍和物质使用共病史的个体，至少有两种物质的缓解风险较低。
相当一部分尼古丁、酒精、大麻或可卡因依赖者在其一生中的某个时候会达到缓解，但缓解的概率和时间因物质和种族/民族群体而异。至少两种物质的缓解预测因素有共同之处，这表明缓解过程是重叠的。共病人格或物质使用障碍的个体缓解率较低，突出了提供协调的精神科和物质滥用干预的必要性。
