Chapman Cath, Slade Tim, Hunt Caroline, Teesson Maree
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia.
NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia.
Drug Alcohol Depend. 2015 Feb 1;147:116-21. doi: 10.1016/j.drugalcdep.2014.11.029. Epub 2014 Dec 10.
This study explored the patterns and correlates of time to first treatment contact among people with alcohol use disorder (AUD) in Australia. Specifically it examined the relationship between sex, birth cohort, onset of AUD symptoms, severity, comorbidity, symptom type and time to first treatment contact (treatment delay) among those with alcohol abuse and dependence in a large population sample.
Data came from the 2007 Australian National Survey of Mental Health and Wellbeing (N=8841). A modified version of the World Health Organization's Composite International Diagnostic Interview was used to determine the presence and age of onset of DSM-IV AUD and other mental disorders and the age at which respondents first sought treatment for alcohol or other drug-related problems.
Median time to first treatment contact for an AUD was 18 years (14 years dependence, 23 years abuse). Projected lifetime treatment rates were 78.1% for alcohol dependence and 27.5% for abuse. Those with earlier onset and from older cohorts reported longer delay and were less likely to ever seek treatment compared to those with later onset or from more recent cohorts. Those with comorbid anxiety but not mood disorder, or who reported alcohol-related role disruption or recurrent interpersonal problems were more likely to ever seek treatment and reported shorter delay compared to those who did not report these symptoms.
Treatment delay for alcohol use disorder in Australia is substantial. Those with earlier onset and those with comorbid mood disorder should be a target for earlier treatment.
本研究探讨了澳大利亚酒精使用障碍(AUD)患者首次治疗接触时间的模式及其相关因素。具体而言,在一个大型人群样本中,研究了酒精滥用和依赖患者的性别、出生队列、AUD症状发作、严重程度、共病情况、症状类型与首次治疗接触时间(治疗延迟)之间的关系。
数据来自2007年澳大利亚全国心理健康与幸福调查(N = 8841)。使用世界卫生组织综合国际诊断访谈的修改版来确定DSM-IV AUD及其他精神障碍的存在、发作年龄以及受访者首次寻求酒精或其他药物相关问题治疗的年龄。
AUD患者首次治疗接触的中位时间为18年(依赖为14年,滥用为23年)。酒精依赖的预计终身治疗率为78.1%,滥用为27.5%。与发病较晚或来自较新队列的患者相比,发病较早且来自较老队列的患者报告的延迟时间更长,且寻求治疗的可能性更小。与未报告这些症状的患者相比,患有共病焦虑但无情绪障碍、或报告有酒精相关角色功能障碍或反复出现人际问题的患者更有可能寻求治疗,且报告的延迟时间更短。
澳大利亚酒精使用障碍的治疗延迟情况严重。发病较早的患者以及患有共病情绪障碍的患者应成为早期治疗的目标。