Toftdahl Nanna Gilliam, Nordentoft Merete, Hjorthøj Carsten
Copenhagen University Hospital, Mental Health Center Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark.
The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.
Soc Psychiatry Psychiatr Epidemiol. 2016 Jan;51(1):129-40. doi: 10.1007/s00127-015-1104-4. Epub 2015 Aug 11.
The present study established the national prevalence of substance use disorders (SUDs) among Danish psychiatric patients. Furthermore, patients with SUDs and those without SUDs were compared on a range of socio-demographic, clinical, and treatment characteristics.
Data were obtained from several Danish population-based registers. The study population was defined as all individuals with incidents of schizophrenia, schizotypal disorder, other psychoses, bipolar disorder, depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and personality disorders since 1969. The prevalence of SUDs was examined for the following psychoactive substances: alcohol, opioids, cannabis, sedatives, cocaine, psycho-stimulants and hallucinogens.
A total of 463,003 patients were included in the analysis. The prevalence of any lifetime SUD was: 37 % for schizophrenia, 35 % for schizotypal disorder, 28 % for other psychoses, 32 % for bipolar disorder, 25 % for depression, 25 % for anxiety, 11 % for OCD, 17% for PTSD, and 46 % for personality disorders. Alcohol use disorder was the most dominating SUD in every psychiatric category (25 % of all included patients). Patients with SUDs were more often men, had fewer years of formal education, more often received disability pension and died due to unnatural causes.
The study was the most comprehensive of its kind so far to estimate the prevalence of SUDs in an unselected population-based cohort, and it revealed remarkably high prevalence among the psychiatric patients. The results should encourage continuous focus on possible comorbidity of psychiatric patients, as well as specialised and integrated treatment along with increased support of patients with comorbid disorders.
本研究确定了丹麦精神病患者中物质使用障碍（SUDs）的全国患病率。此外，还对患有SUDs的患者和未患有SUDs的患者在一系列社会人口统计学、临床和治疗特征方面进行了比较。
数据来自丹麦多个基于人群的登记处。研究人群定义为自1969年以来患有精神分裂症、分裂型障碍、其他精神病性障碍、双相情感障碍、抑郁症、焦虑症、强迫症（OCD）、创伤后应激障碍（PTSD）和人格障碍的所有个体。研究了以下精神活性物质的SUDs患病率：酒精、阿片类药物、大麻、镇静剂、可卡因、精神兴奋剂和致幻剂。
共有463,003名患者纳入分析。任何终生SUD的患病率为：精神分裂症37%，分裂型障碍35%，其他精神病性障碍28%，双相情感障碍32%，抑郁症25%，焦虑症25%，强迫症11%，创伤后应激障碍17%，人格障碍46%。酒精使用障碍是每个精神科类别中最主要的SUD（占所有纳入患者的25%）。患有SUDs的患者男性居多，正规教育年限较少，更常领取残疾抚恤金，且死于非自然原因。
该研究是迄今为止同类研究中最全面的，旨在估计未选择的基于人群队列中SUDs的患病率，研究发现精神病患者中的患病率极高。研究结果应促使人们持续关注精神病患者可能存在的共病情况，以及针对合并症患者的专门和综合治疗及更多支持。
