Bradizza Clara M, Stasiewicz Paul R, Dermen Kurt H
Research Institute on Addictions University at Buffalo - State University of New York 1021 Main Street Buffalo, New York Tel. 716-887-2532 Fax. 716-887-2215
Research Institute on Addictions University at Buffalo - State University of New York 1021 Main Street Buffalo, New York Tel. 716-887-2596 Fax. 716-887-2477
Curr Addict Rep. 2014 Dec 1;1(4):243-250. doi: 10.1007/s40429-014-0032-9.
The prevalence of substance abuse among severely mentally ill individuals (SMI) with a schizophrenia-spectrum or bipolar disorder is about three times the rate of the general population. However, few effective interventions exist to address the problem. In this paper, we evaluate recent studies of behavioral interventions for substance abuse among SMI individuals. These include cognitive-behavioral, motivational interviewing, and contingency management interventions, as well as combinations thereof. Consistent with prior systematic reviews, ours indicates that no behavioral intervention has clearly demonstrated efficacy beyond that of usual care. Unfortunately, most of the reviewed studies suffer from methodological problems that hamper detection of treatment effects. Also, it can be argued that interventions tested thus far may not be well-suited for this cognitively-impaired population. A programmatic series of studies is needed to further develop and test behavioral interventions for treating substance abuse in this population.
患有精神分裂症谱系障碍或双相情感障碍的重度精神病患者（SMI）中药物滥用的患病率约为普通人群的三倍。然而，几乎没有有效的干预措施来解决这一问题。在本文中，我们评估了近期针对SMI个体药物滥用的行为干预研究。这些干预措施包括认知行为疗法、动机性访谈和应急管理干预，以及它们的组合。与之前的系统评价一致，我们的研究表明，没有任何行为干预措施比常规护理更具明显疗效。不幸的是，大多数被审查的研究都存在方法学问题，这妨碍了对治疗效果的检测。此外，可以认为，迄今为止所测试的干预措施可能并不适合这一认知受损人群。需要开展一系列有计划的研究，以进一步开发和测试针对该人群药物滥用治疗的行为干预措施。
