Department of Addiction Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland.
J Stud Alcohol Drugs. 2011 Sep;72(5):872-80. doi: 10.15288/jsad.2011.72.872.
Alcohol dependence and affective disorders are significant health problems, and their co-occurrence is mutually detrimental. There are few long-term studies on the impact of treatment on the prognosis of these comorbid disorders. We wished to study if the impact of effective inpatient integrated treatment for these co-occurring disorders was maintained 2 years after discharge from the hospital.
A total of 189 patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for alcohol dependence and either bipolar disorder or depression were recruited, assessed, and assigned to an inpatient treatment unit. Following intensive integrated treatment that was designed to integrate psychotherapy with pharmacotherapy, affective disorder with substance use disorder treatment, and inpatient with outpatient therapy, this population was followed for 2 years after discharge.
Treatment improvements above baseline that were achieved over the course of the 4-week intensive inpatient treatment were essentially maintained over a 2-year outpatient period. Depression, elation, anxiety, and craving scores all fell, as did all drinking outcome measures in both depressed and bipolar alcohol-dependent groups. Findings suggested that women with a diagnosis of bipolar disorder reported higher levels of depression and anxiety symptoms than male bipolar patients at 2-year follow-up. More women than men remained abstinent at 2 years after treatment, with this difference mainly in the depressed sample.
Comorbid bipolar alcoholics and depressed alcoholics can be treated successfully together on an integrated inpatient treatment program, and the benefits can last for up to 2 years. There also appeared to be significant gender differences in treatment outcomes.
酒精依赖和情感障碍是严重的健康问题，两者同时存在会相互影响。关于治疗对这些共病的预后的影响，长期研究较少。我们希望研究这些共病患者在出院后 2 年内，有效住院综合治疗对其预后的影响是否能保持。
共招募了 189 名符合《精神障碍诊断与统计手册》第 4 版酒精依赖标准且符合双相情感障碍或抑郁症标准的患者，对他们进行评估并分配到住院治疗单元。在接受旨在整合心理治疗与药物治疗、情感障碍与物质使用障碍治疗、住院治疗与门诊治疗的强化综合治疗后，对这部分患者进行了 2 年的随访。
在 4 周强化住院治疗过程中取得的治疗改善在 2 年的门诊随访期间基本保持。抑郁、兴奋、焦虑和渴求评分均下降，双相和抑郁酒精依赖组的所有饮酒结局指标也均下降。研究结果表明，在 2 年随访时，被诊断为双相情感障碍的女性报告的抑郁和焦虑症状比男性双相情感障碍患者更高。治疗后 2 年，更多女性而非男性保持戒酒状态，这种差异主要存在于抑郁组。
共病双相酒精依赖者和抑郁酒精依赖者可以在综合住院治疗计划中一起成功治疗，且治疗效果可持续长达 2 年。治疗结果似乎存在显著的性别差异。
