National Addictions Management Service (NAMS), Institute of Mental Health (IMH), Singapore.
Drug Alcohol Rev. 2011 Jul;30(4):441-7. doi: 10.1111/j.1465-3362.2011.00301.x.
INTRODUCTIONS AND AIMS: Research from western countries indicates that family members of addiction patients report heightened stress and psychological morbidity. This current study aimed to examine stress, coping behaviours, related morbidity and subsequent resource utilisation among family members of patients attending a national treatment program in Singapore.
The study used a matched case-control design. One hundred family members of addiction patients attending treatment and 100 matched controls completed a semi-structured interview with a researcher. This included the Beck Depression Inventory-II, Short-Form Health Survey-36, General Health Questionnaire-28, Perceived Stress Scale, Family Member Impact Scale and Coping Questionnaire, and also assessed service utilisation.
T-tests revealed significantly greater depression, stress and psychiatric morbidity and poorer overall well-being (Short-Form Health Survey-36) among family members compared with controls. Despite the apparent negative impact on mental health, their physical morbidity did not differ from controls and services utilisation was low. Tolerant-inactive coping was found to be most strongly correlated with psychological well-being. Multivariate analysis indicated that perceived stress was the strongest predictor of overall strain (General Health Questionnaire), but this was not moderated by coping style.
Subjective appraisal of stress and coping responses are essential factors affecting the morbidity of family members. Family members demonstrated a need and willingness to engage in formal treatment/counselling for their own problems that were attributed to living with an addiction patient. This provides an opportunity for stress management and brief interventions to modify coping styles, thereby minimizing the potential negative mental health impact on family members.
介绍与说明 ：来自西方国家的研究表明，成瘾患者的家属报告称压力和心理发病率增加。本研究旨在考察新加坡全国治疗计划中患者家属的压力、应对行为、相关发病率和后续资源利用情况。
本研究采用了匹配病例对照设计。100 名成瘾患者家属和 100 名匹配对照者与一名研究人员一起完成了半结构化访谈。访谈内容包括贝克抑郁量表第二版、简明健康调查量表 36 项、一般健康问卷 28 项、感知压力量表、家庭成员影响量表和应对问卷，同时评估了服务利用情况。
t 检验显示，与对照组相比，患者家属的抑郁、压力和精神发病率明显更高，整体健康状况更差（简明健康调查量表 36 项）。尽管对心理健康有明显的负面影响，但他们的身体发病率与对照组没有差异，服务利用率也很低。容忍-不活跃的应对方式与心理健康呈最强相关。多变量分析表明，感知压力是总体压力（一般健康问卷）的最强预测因素，但应对方式并不能调节这种关系。
压力和应对反应的主观评估是影响家庭成员发病率的重要因素。家庭成员表现出需要并愿意为自己的问题接受正式的治疗/咨询，这些问题归因于与成瘾患者一起生活。这为压力管理和简短干预提供了机会，以改变应对方式，从而最大限度地减少对家庭成员潜在的负面心理健康影响。
