Daigre Constanza, Grau-López Lara, Rodríguez-Cintas Laia, Ros-Cucurull Elena, Sorribes-Puertas Marta, Esculies Oriol, Bones-Rocha Katia, Roncero Carlos
Addiction and Dual Diagnosis Unit, Psychiatry Deparment, Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Agencia de Salud Pública de Barcelona, CIBERSAM, Barcelona, Spain.
Projecte Home Catalunya, Catalunya, Spain.
Qual Life Res. 2017 Dec;26(12):3201-3209. doi: 10.1007/s11136-017-1668-4. Epub 2017 Aug 7.
The comorbidity of any substance use disorder and another mental disorder is defined as dual diagnosis. Dual diagnosis is very common and clinical and therapeutic consequences have been described. This cross-sectional study aimed to analyse health-related quality of life (HRQoL) according to clinical characteristics and psychiatric comorbidities in patients with substance dependence.
A total of 1276 substance-dependent patients seeking treatment were recruited. HRQoL was evaluated by the Short-Form 36 (SF-36) questionnaire. The SCID-I, SCID-II and Conners' adult ADHD diagnostic interview were used to evaluate dual diagnosis. A visual analogue scale was used to measure craving. Bivariate and multivariate analyses were performed, and correction for multiple tests was conducted.
Substance-dependent patients had impaired quality of life, especially in the mental component. SF-36 physical and mental component scores were 47.7 ± 10.9 and 36.1 ± 14.1, respectively. Furthermore, 65% of the patients had dual diagnosis, 51% had an Axis I DSM-IV-TR mental disorder and 35% had some personality disorder. Impaired physical quality of life was independently associated with medical condition, age, being female, depressive disorder and anxiety disorder. Depression disorder, any personality disorder, active consumption last month, Attention deficit hyperactivity disorder, anxiety disorder, suicide attempt were independently associated with worse mental quality of life.
These findings emphasize the significance of dual diagnosis in the impairment of HRQoL in substance-dependent patients, particularly with regard to mental component. In addicted patients with low scores on SF-36, psychiatric comorbidity should be evaluated and treated in an integrated approach.
任何物质使用障碍与另一种精神障碍的共病被定义为双重诊断。双重诊断非常常见，并且已经描述了其临床和治疗后果。这项横断面研究旨在根据物质依赖患者的临床特征和精神共病情况分析健康相关生活质量（HRQoL）。
共招募了1276名寻求治疗的物质依赖患者。通过简短健康调查问卷36项版本（SF - 36）评估HRQoL。使用精神疾病诊断与统计手册第四版轴I障碍定式临床访谈量表（SCID - I）、精神疾病诊断与统计手册第四版轴II障碍定式临床访谈量表（SCID - II）以及康纳斯成人注意力缺陷多动障碍诊断访谈来评估双重诊断。使用视觉模拟量表测量渴望程度。进行了双变量和多变量分析，并对多重检验进行了校正。
物质依赖患者的生活质量受损，尤其是在精神方面。SF - 36身体和精神成分得分分别为47.7±10.9和36.1±14.1。此外，65%的患者有双重诊断，51%有精神疾病诊断与统计手册第四版轴I精神障碍，35%有某种人格障碍。身体生活质量受损与身体状况、年龄、女性、抑郁症和焦虑症独立相关。抑郁症、任何人格障碍、上个月的活跃物质使用、注意力缺陷多动障碍、焦虑症、自杀未遂与较差的精神生活质量独立相关。
这些发现强调了双重诊断在物质依赖患者HRQoL损害中的重要性，特别是在精神成分方面。对于SF - 36得分低的成瘾患者，应综合评估和治疗精神共病。
