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患有共病的年轻人:物质使用障碍的治疗反应与结果

Young adults with co-occurring disorders: substance use disorder treatment response and outcomes.

作者信息

Bergman Brandon G, Greene M Claire, Slaymaker Valerie, Hoeppner Bettina B, Kelly John F

机构信息

Center for Addiction Medicine, Massachusetts General Hospital, Boston MA; Center for Addiction Medicine, Harvard Medical School, Boston MA.

Center for Addiction Medicine, Massachusetts General Hospital, Boston MA.

出版信息

J Subst Abuse Treat. 2014 Apr;46(4):420-8. doi: 10.1016/j.jsat.2013.11.005. Epub 2013 Dec 21.

Abstract

Compared to other life stages, young adulthood (ages 18-24) is characterized by qualitative differences including the highest rates of co-occurring substance use and psychiatric disorders (COD). Little is known, however, regarding young adults' response to substance use disorder (SUD) treatment, especially those with COD. Greater knowledge in this area could inform and enhance the effectiveness and efficiency of SUD care for this patient population. The current study investigated differences between 141 COD and 159 SUD-only young adults attending psychiatrically-integrated residential SUD treatment on intake characteristics, during-treatment changes on clinical targets (e.g., coping skills; abstinence self-efficacy), and outcomes during the year post-discharge. Contrary to expectations, despite more severe clinical profiles at intake, COD patients showed similar during-treatment improvements on clinical target variables, and comparable post-treatment abstinence rates and psychiatric symptoms. Clinicians referring young adults with COD to specialized care may wish to consider residential SUD treatment programs that integrate evidence-based psychiatric services.

摘要

与其他生命阶段相比,青年期(18至24岁)具有质的差异,包括同时出现物质使用和精神障碍(COD)的比率最高。然而,对于青年对物质使用障碍(SUD)治疗的反应,尤其是那些患有COD的青年,我们所知甚少。该领域更多的知识可以为针对这一患者群体的SUD护理的有效性和效率提供信息并加以提高。本研究调查了141名患有COD的青年和159名仅患有SUD的青年在接受精神科综合住院SUD治疗时的入院特征差异、治疗期间临床指标(如应对技能;戒酒自我效能感)的变化以及出院后一年内的结果。与预期相反,尽管入院时临床情况更严重,但患有COD的患者在治疗期间临床指标变量上的改善相似,治疗后的戒酒率和精神症状也相当。将患有COD的青年转诊至专科护理的临床医生不妨考虑采用整合了循证精神科服务的住院SUD治疗项目。

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