Danovitch Itai
a Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center , Los Angeles , California , USA.
J Addict Dis. 2016 Jul-Sep;35(3):169-79. doi: 10.1080/10550887.2016.1168212. Epub 2016 Mar 24.
Post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Compared to individuals with opioid use disorder alone, those with post-traumatic stress disorder have a worse course of illness, occupational functioning, and physical health. The neurobiological pathways underlying each disorder overlap substantially, and there are multiple pathways through which these disorders may interact. This narrative review explores evidence underpinning 3 explanatory perspectives on comorbid post-traumatic stress disorder and opioid use disorder: The opioid susceptibility model (a.k.a.: the Self-Medication Hypothesis), the post-traumatic stress disorder susceptibility model, and the common factors model. Diagnostic implications, treatment implications, and directions for future research are discussed.
创伤后应激障碍在患有阿片类药物使用障碍的个体中极为普遍。与仅患有阿片类药物使用障碍的个体相比，患有创伤后应激障碍的个体病情、职业功能和身体健康状况更差。每种障碍背后的神经生物学途径有很大重叠，并且这些障碍可能通过多种途径相互作用。本叙述性综述探讨了支持创伤后应激障碍与阿片类药物使用障碍共病的三种解释性观点的证据：阿片类药物易感性模型（又称：自我用药假说）、创伤后应激障碍易感性模型和共同因素模型。还讨论了诊断意义、治疗意义以及未来研究方向。
