Cui Ruifeng, Tate Susan R, Cummins Kevin, Skidmore Jessica R, Brown Sandra A
1Veterans Affairs San Diego Healthcare System, Research Service , San Diego, California , USA.
Subst Use Misuse. 2015 Jan;50(2):174-83. doi: 10.3109/10826084.2014.962052. Epub 2014 Oct 7.
Physical illnesses frequently co-occur with depression and substance use disorders and may impact their improvement. Physical illness symptoms may overlap with or exacerbate somatic symptoms of depression. Individuals may use substances to cope with symptoms of physical illness.
We examined whether chronic physical health problems moderated changes in depression and substance use among dual diagnosed individuals during and in the year following treatment.
Participants were recruited from a Veterans Affairs dual diagnosis outpatient program between March 2000 and November 2007 and were randomized to either Integrated Cognitive-Behavioral Therapy or Twelve-Step Facilitation Therapy. A total of 214 veterans with assessment data for the variables of interest were included in analyses. Participants completed quarterly depression, substance use, and health assessments over an 18 month period. We used linear-mixed effects models to analyze patterns of change for depression and substance use.
Individuals with severe chronic health problems and higher intake depression showed slower improvements in both nonsomatic and somatic depression symptoms. Individuals with severe chronic health problems and higher midtreatment substance use showed less improvement in substance use.
Assessing and addressing physical health issues during depression and substance use disorder treatment may improve outcomes.
身体疾病常与抑郁症和物质使用障碍同时出现，并可能影响其改善情况。身体疾病症状可能与抑郁症的躯体症状重叠或使其加重。个体可能会使用物质来应对身体疾病的症状。
我们研究了慢性身体健康问题是否会调节双重诊断个体在治疗期间及治疗后一年内抑郁症和物质使用情况的变化。
参与者于2000年3月至2007年11月从退伍军人事务部双重诊断门诊项目中招募，并被随机分配到综合认知行为疗法或十二步促进疗法。共有214名具有感兴趣变量评估数据的退伍军人纳入分析。参与者在18个月内每季度完成一次抑郁症、物质使用和健康评估。我们使用线性混合效应模型来分析抑郁症和物质使用的变化模式。
患有严重慢性健康问题且治疗初期抑郁症程度较高的个体，其非躯体和躯体抑郁症症状的改善较慢。患有严重慢性健康问题且治疗中期物质使用量较高的个体，其物质使用情况的改善较少。
在抑郁症和物质使用障碍治疗期间评估并解决身体健康问题可能会改善治疗效果。
