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共病物质使用障碍与精神障碍的神经生物学:证据现状

Neurobiology of Comorbid Substance Use Disorders and Psychiatric Disorders: Current State of Evidence.

作者信息

Balhara Yatan Pal Singh, Kuppili Pooja Patnaik, Gupta Rishab

机构信息

Yatan Pal Singh Balhara, MD, DNB (Psychiatry), MNAMS, Department of Psychiatry, National Drug Dependence Treatment Centre, WHO Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, New Delhi; and Regional Mentor, International Programme in Addiction Studies Master of Science in Addiction Studies King's College London, UK; University of Adelaide, Australia; Virginia Commonwealth University.Pooja Patnaik Kuppili, MD (Psychiatry) and Rishab Gupta, MD (Psychiatry), Department of Psychiatry, All India Institute of Medical Sciences, New Delhi.

出版信息

J Addict Nurs. 2017 Jan/Mar;28(1):11-26. doi: 10.1097/JAN.0000000000000155.

Abstract

BACKGROUND

"Dual disorder" or "dual diagnosis" refers to the co-occurrence of substance use disorder and psychiatric disorders. Prospective studies have shown that treatment outcomes, such as symptom levels, hospitalization rates, housing stability, and functional status, are worse among the patients with dual disorders as compared with those who have either of these disorders.

OBJECTIVES

The current article is aimed at reviewing the current state of evidence on neurobiology of dual disorders. Given the high prevalence of co-occurrence of substance use disorder and psychiatric disorders, it is important to explore the various facets of this association. The current review assimilates the information on neurobiological research on dual disorders and helps the readers gain insights into the current understanding on this theme.

METHODS

The electronic database of PubMed was searched for relevant publications.

RESULTS

The studies included in the review belonged to various domains of neurobiology including neuropathology, structural neuroimaging, functional neuroimaging, genetics, neurochemicals/neuroreceptors, and neuroendocrinology. Forty studies were included in the review.

CONCLUSIONS

Most of the issues related to the neurobiology of dual disorders remain inadequately studied. However, the current evidence suggests that the individuals with co-occurring disorders are likely to differ from those with either substance use disorders or psychiatric disorders alone on various neurobiological aspects. Hence, it is imperative to systematically study the various neurobiological aspects of dual disorders in the future.

摘要

背景

“双重障碍”或“双重诊断”指物质使用障碍与精神障碍同时存在。前瞻性研究表明,与仅患有其中一种障碍的患者相比,双重障碍患者的治疗结果,如症状水平、住院率、住房稳定性和功能状态更差。

目的

本文旨在综述双重障碍神经生物学的现有证据状况。鉴于物质使用障碍与精神障碍同时存在的高发生率,探索这种关联的各个方面很重要。本综述汇总了关于双重障碍神经生物学研究的信息,有助于读者深入了解对这一主题的当前认识。

方法

在PubMed电子数据库中搜索相关出版物。

结果

纳入综述的研究属于神经生物学的各个领域,包括神经病理学、结构神经影像学、功能神经影像学、遗传学、神经化学物质/神经受体和神经内分泌学。本综述纳入了40项研究。

结论

与双重障碍神经生物学相关的大多数问题仍未得到充分研究。然而,目前的证据表明,同时患有这两种障碍的个体在各种神经生物学方面可能与仅患有物质使用障碍或精神障碍的个体不同。因此,未来有必要系统地研究双重障碍的各种神经生物学方面。

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