Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany.
Psychopathology. 2014;47(2):133-40. doi: 10.1159/000351784. Epub 2013 Aug 7.
This study focuses on the systematic psychiatric evaluation of polydrug-using opiate-dependent patients, using the standard DSM-IV diagnostic interviews and a new psychodynamic instrument operationalizing personality organization (Structured Interview of Personality Organization, STIPO).
50 patients were interviewed with the Structured Clinical Interview for DSM-IV Disorders (SCID) I and II and the STIPO by two independent researchers at a detoxification treatment unit.
According to the SCID I and II, all patients had at least one axis I disorder, 90% at least one axis II disorder. A correspondence was found between STIPO and SCID results, in that more pathology in the SCID coincided with more severity in the STIPO. According to the STIPO, 100% of the patients were located at the level of borderline personality organization, indicating identity pathology according to Kernberg's model.
Given the fact that comorbid psychiatric disorders compromise the outcome of detoxification and dehabituation treatments, it is highly relevant to diagnose these disorders and to assess underlying personality pathology. While the evidence of psychosocial treatments in addiction therapy is still weak, the integration of syndrome-tailored treatment modules may help improve the treatment of patients with this chronically relapsing condition.
small sample size.
本研究专注于对使用多种药物的阿片类药物依赖患者进行系统的精神科评估，使用标准的 DSM-IV 诊断访谈和一种新的精神动力学工具来操作人格组织（人格组织结构化访谈，STIPO）。
50 名患者在戒毒治疗单位由两名独立研究人员使用 DSM-IV 障碍的结构化临床访谈（SCID）I 和 II 以及 STIPO 进行访谈。
根据 SCID I 和 II，所有患者至少有一种轴 I 障碍，90%至少有一种轴 II 障碍。STIPO 与 SCID 结果之间存在对应关系，即 SCID 中的更多病理学与 STIPO 中的更多严重性相吻合。根据 STIPO，100%的患者处于边缘型人格组织水平，根据 Kernberg 模型表明存在身份病理学。
鉴于共病精神障碍会影响戒毒和脱毒治疗的效果，诊断这些障碍并评估潜在的人格病理学非常重要。虽然成瘾治疗中的心理社会治疗证据仍然薄弱，但整合针对综合征的治疗模块可能有助于改善对这种慢性复发疾病患者的治疗。
样本量小。
