Landreat M-G, Vigneau C Victorri, Bronnec M Grall, Sebille-Rivain V, Venisse J-L, Jolliet P
Service d'addictologie, centre hospitalier des Pays-de-Morlaix, France.
Encephale. 2011 Dec;37(6):418-24. doi: 10.1016/j.encep.2010.09.002. Epub 2011 Jul 8.
Lots of similar vulnerabilities to substance use disorders are described in the literature: clinical, genetics, family, environment, etc. Although, when we follow up patients, we know perfectly well that there are also differences due to the substance mainly causing addiction. But we found very little research on the differences between various substance use disorders according to the substance mainly causing dependence.
Our main hypothesis was that significant differences do not exist in medical and social data between patients with substance use disorders according to the substance mainly used. We expected to find significant differences between illegal substance use disorders (opiates, cocaine, cannabis) and legal substance use disorders (BZD, alcohol).
Our study aimed to identify differences between patients with substance related disorders in medical and social data according to the main addictive substance.
A specific software has been created by the CEIP and the Department of Addictology of Nantes University Hospital. Anonymous data were gathered and all patients gave their written consent. This database has been declared to CNIL (number 1350706). All data have been directly collected by the physician during medical consultation. The following data were recorded during the first medical examination: age, sex, illicit substance use, prior criminal record or psychiatric disorders, prior addictive behaviours among relatives and/or friends, family history (divorce, separation, abandonment). Other data were gathered prospectively: socioprofessional insertion, marital status, drug prescriptions (time and duration).
We found significant differences in social (age, sex) and medical data (prior psychiatric disorders) between patients according to the substance causing dependence. We identified five profiles depending on the substance: cannabis, cocaine, heroin, alcohol and benzodiazepine.
We clearly identified different types of patient's profiles according to substances mainly causing addiction. These differences can modify our strategies of prevention and treatment, so as to meet patients' needs better.
文献中描述了许多与物质使用障碍相似的易感性因素:临床、遗传学、家庭、环境等。然而,在对患者进行随访时,我们清楚地知道,由于主要导致成瘾的物质不同,也存在差异。但我们发现,关于根据主要导致依赖的物质对各种物质使用障碍之间差异的研究非常少。
我们的主要假设是,根据主要使用的物质,物质使用障碍患者的医学和社会数据不存在显著差异。我们期望在非法物质使用障碍(阿片类药物、可卡因、大麻)和合法物质使用障碍(苯二氮䓬类药物、酒精)之间发现显著差异。
我们的研究旨在根据主要成瘾物质确定物质相关障碍患者在医学和社会数据方面的差异。
由CEIP和南特大学医院成瘾学系创建了一个特定软件。收集了匿名数据,所有患者均给予书面同意。该数据库已向法国国家信息与自由委员会申报(编号1350706)。所有数据均由医生在医疗咨询期间直接收集。在首次医学检查时记录了以下数据:年龄、性别、非法物质使用情况、既往犯罪记录或精神疾病、亲属和/或朋友的既往成瘾行为、家族病史(离婚、分居、遗弃)。前瞻性收集了其他数据:社会职业融入情况、婚姻状况、药物处方(时间和持续时间)。
根据导致依赖的物质,我们发现患者在社会(年龄、性别)和医学数据(既往精神疾病)方面存在显著差异。我们根据物质确定了五种类型。
我们根据主要导致成瘾的物质明确确定了不同类型的患者。这些差异可以改变我们的预防和治疗策略,以便更好地满足患者的需求。