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美沙酮维持治疗患者美沙酮剂量与共病精神障碍之间的相关性

The Correlation between Methadone Dosage and Comorbid Psychiatric Disorders in Patients on Methadone Maintenance Treatment.

作者信息

Parvaresh Nooshin, Masoudi Arman, Majidi-Tabrizi Shiva, Mazhari Shahrzad

机构信息

Assistant Professor, Child and Adolescent Psychiatrist, Neuroscience Research Center AND School of Medicine, Department of Psychiatry, Kerman University of Medical Sciences, Kerman, Iran.

Resident, Department of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

Addict Health. 2012 Winter-Spring;4(1-2):1-8.

Abstract

BACKGROUND

Methadone Maintenance Treatment is a useful method for opioid dependents, which results in harm reduction and increased quality of life in opioid dependents. The prevalence of psychiatric disorders in addicts is higher than in the general population which can interfere with the course and treatment of substance dependents and decrease the efficacy of treatment.

METHODS

This descriptive, cross-sectional study was aimed to determine the correlation between psychiatric disorders and methadone dosage. It was performed on 154 patients of Kerman Shahid Beheshti Hospital's Methadone Clinic during a six month period from Dec 2010 to Jul 2011. The study population was chosen by convenience sampling. The searching tools were Socio-Demographic Questionnaire, psychiatric structured interview based on DSM-IV-TR, Beck Depression Inventory, Young Mania Rating Scales, and Anxiety and Depression Rating Scales.

FINDINGS

Significant correlations were observed between increased methadone dosage and antisocial personality disorder. In addition, significant positive correlations were observed between increased methadone dosage and Hamilton anxiety scores, Hamilton depression scores and Young Mania scores.

CONCLUSION

High methadone dosage may be a marker of coexisting psychiatric disorders in patients on methadone maintenance treatment which indicates the necessity of devoting further attention to this group. Psychiatric services should be open and accessible to the patients, especially those who seek treatment voluntarily. Early diagnosis and treatment of patients with coexisting psychiatric disorders may increase the efficacy of methadone maintenance treatment.

摘要

背景

美沙酮维持治疗是一种针对阿片类药物依赖者的有效方法,可减少伤害并提高阿片类药物依赖者的生活质量。成瘾者中精神障碍的患病率高于普通人群,这可能会干扰物质依赖者的病程和治疗,并降低治疗效果。

方法

这项描述性横断面研究旨在确定精神障碍与美沙酮剂量之间的相关性。研究于2010年12月至2011年7月的六个月期间,在克尔曼沙希德·贝赫什提医院美沙酮诊所的154名患者中进行。研究人群通过便利抽样选取。检索工具包括社会人口学问卷、基于《精神疾病诊断与统计手册》第四版修订版(DSM-IV-TR)的精神科结构化访谈、贝克抑郁量表、杨氏躁狂评定量表以及焦虑和抑郁评定量表。

结果

观察到美沙酮剂量增加与反社会人格障碍之间存在显著相关性。此外,美沙酮剂量增加与汉密尔顿焦虑评分、汉密尔顿抑郁评分和杨氏躁狂评分之间存在显著正相关。

结论

高剂量美沙酮可能是美沙酮维持治疗患者并存精神障碍的一个标志,这表明有必要对该群体给予更多关注。精神科服务应对患者开放且可及,尤其是那些自愿寻求治疗的患者。对并存精神障碍患者的早期诊断和治疗可能会提高美沙酮维持治疗的效果。

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