精神困扰与多药滥用之间的共现情况:一项对物质滥用治疗患者的十年前瞻性研究。

Co-occurrence between mental distress and poly-drug use: a ten year prospective study of patients from substance abuse treatment.

作者信息

Burdzovic Andreas Jasmina, Lauritzen Grethe, Nordfjaern Trond

机构信息

Norwegian Institute for Alcohol and Drug Research (SIRUS), Øvre Slottsgate 2B, 0157 Oslo, Norway.

Norwegian Institute for Alcohol and Drug Research (SIRUS), Øvre Slottsgate 2B, 0157 Oslo, Norway.

出版信息

Addict Behav. 2015 Sep;48:71-8. doi: 10.1016/j.addbeh.2015.05.001. Epub 2015 May 8.

Abstract

INTRODUCTION

Longitudinal research investigating psychiatric trajectories among patients with poly-drug use patterns remains relatively scant, even though this specific population is at elevated risk for multiple negative outcomes. The present study examined temporal associations between poly-drug use (i.e. heroin, cannabis, tranquilizers, and amphetamines) and mental distress over a 10-year period.

METHODS

A clinical cohort of 481 patients was recruited from substance use treatment facilities in Norway, and prospectively interviewed 1, 2, 7 and 10years after the initial data collection at treatment admission. At each assessment participants completed a questionnaire addressing their substance use and mental distress. Longitudinal growth models were used to examine whether, and if so, how, levels of drug use were associated with the level and rate of change in mental distress over time.

RESULTS

Results from the longitudinal growth models showed a co-occurrence between active poly-drug use and mental distress, such that there was a dose-response effect where mental distress increased both in magnitude and over time with the number of drugs used. Reduction in mental distress during the 10-year study period was evident only in the no-drug use condition. Use of multiple drugs and mental distress appear strongly co-related over time.

CONCLUSIONS

Pre-treatment assessment should carefully identify individuals manifesting poly-drug use and mental disorders. Treatment and follow-up services should be tailored to their specific needs.

摘要

引言

尽管多药使用模式的患者群体面临多种负面后果的风险较高,但对该群体精神疾病发展轨迹的纵向研究仍然相对较少。本研究考察了10年间多药使用(即海洛因、大麻、镇静剂和安非他命)与精神痛苦之间的时间关联。

方法

从挪威的物质使用治疗机构招募了481名患者组成临床队列,并在治疗入院时首次收集数据后的1年、2年、7年和10年进行前瞻性访谈。每次评估时,参与者都要完成一份关于其物质使用和精神痛苦的问卷。纵向增长模型用于检验药物使用水平是否以及如何与精神痛苦随时间的水平和变化率相关。

结果

纵向增长模型的结果显示,多药使用活跃期与精神痛苦同时出现,存在剂量反应效应,即精神痛苦的程度和随时间的变化都随着使用药物的数量增加而增加。在10年研究期间,只有在不使用药物的情况下,精神痛苦才明显减轻。随着时间的推移,多种药物的使用与精神痛苦似乎密切相关。

结论

治疗前评估应仔细识别表现出多药使用和精神障碍的个体。治疗和后续服务应根据他们的具体需求进行定制。

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