Glasner-Edwards Suzette, Mooney Larissa J, Ang Alfonso, Hillhouse Maureen, Rawson Richard
UCLA Integrated Substance Abuse Programs.
J Dual Diagn. 2013 Apr 1;9(2):123-128. doi: 10.1080/15504263.2013.779157.
Although trauma is a well-established risk factor for substance use disorders, little is known about the association between posttraumatic stress disorder (PTSD) and treatment outcomes among methamphetamine users. In the present study, we examine the relationship between PTSD and post-treatment methamphetamine use outcomes, hospitalizations, and overall psychiatric impairment.
Using data from 526 adults in the largest psychosocial clinical trial of methamphetamine users conducted to date, this study examined: (1) treatment outcomes of methamphetamine users with concomitant PTSD three years after psychosocial treatment for methamphetamine dependence; and (2) PTSD symptom clusters as risk factors for post-treatment relapse to methamphetamine use.
PTSD was associated with poorer methamphetamine use outcomes; methamphetamine use frequency throughout the 3-year follow-up was significantly greater among individuals with a PTSD diagnosis, and those with PTSD had more than five times the odds of reporting methamphetamine use in the 30 days prior to the follow-up interview, = 5.2, 95% CI [2.0-13.3]. Additionally, higher levels of other Axis I psychopathology were observed among methamphetamine users with PTSD. Avoidance and arousal symptoms predicted post-treatment methamphetamine use.
Addressing these high risk PTSD symptoms and syndromes in methamphetamine users may be helpful as a means of improving treatment outcomes in this population.
虽然创伤是物质使用障碍的一个公认风险因素,但对于创伤后应激障碍(PTSD)与甲基苯丙胺使用者治疗结果之间的关联却知之甚少。在本研究中,我们探讨了PTSD与甲基苯丙胺使用后治疗结果、住院情况及整体精神障碍之间的关系。
利用来自526名成年人的数据,这些数据来自于迄今为止针对甲基苯丙胺使用者开展的最大规模社会心理临床试验,本研究考察了:(1)伴有PTSD的甲基苯丙胺使用者在接受甲基苯丙胺依赖社会心理治疗三年后的治疗结果;以及(2)PTSD症状群作为甲基苯丙胺使用后复发的风险因素。
PTSD与较差的甲基苯丙胺使用结果相关;在整个3年随访期间,被诊断患有PTSD的个体甲基苯丙胺使用频率显著更高,且患有PTSD的个体在随访访谈前30天内报告使用甲基苯丙胺的几率是其他人的五倍多,比值比 = 5.2,95%置信区间[2.0 - 13.3]。此外,在患有PTSD的甲基苯丙胺使用者中观察到其他轴I精神病理学水平更高。回避和觉醒症状可预测治疗后甲基苯丙胺的使用情况。
解决甲基苯丙胺使用者中这些高风险的PTSD症状和综合征,可能有助于改善该人群的治疗结果。