Schoenthaler Stephen J, Blum Kenneth, Fried Lyle, Oscar-Berman Marlene, Giordano John, Modestino Edward J, Badgaiyan Rajendra
Department of Sociology, California State University, Stanislaus, Turlock, CA, USA.
Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA.
J Syst Integr Neurosci. 2017 Jul;3(4). doi: 10.15761/JSIN.1000169. Epub 2017 Jul 17.
This multi-center study of dual diagnosis (DD) programs involved 804 residential patients with co-occurring alcohol and mental health disorders. The Addiction Severity Index was administered at admission and at one, six, and 12 months after discharge. Repeated measures analysis showed the intoxication rate per month stabilized between months six and 12 with 68% still in remission and an 88% mean reduction from baseline (F = 519, p < .005). A comparison between patients with and without weekly relapse produced significant differences in hospitalization (odds ratio 11.3:1; 95% C.I., 5.5 to 23.2). Eight ANCOVAs used mean intoxication days per month after discharge as the outcome variable, pre-admission intoxication days per month as a covariate, and eight variables associated with relapse (e.g. depression) as factors. Patients with these factors at admission did not have significantly higher intoxication rates after discharge than patients without them. This suggests that these DD programs successfully integrated treatment of both disorders and explained their effectiveness. Co-occurring DSM IV mood disorders such as anxiety and depression as well as drug abuse involving opioids or cocaine fell between 66 and 95% at months one, six, and twelve.
这项关于双重诊断（DD）项目的多中心研究涉及804名同时患有酒精和心理健康障碍的住院患者。在入院时以及出院后1个月、6个月和12个月时进行了成瘾严重程度指数评估。重复测量分析显示，每月的中毒率在第6个月至第12个月之间稳定下来，68%的患者仍处于缓解状态，平均较基线水平降低了88%（F = 519，p < .005）。有每周复发情况的患者与无复发情况的患者在住院治疗方面存在显著差异（优势比为11.3:1；95%置信区间为5.5至23.2）。八项协方差分析将出院后每月的平均中毒天数作为结果变量，入院前每月的中毒天数作为协变量，并将八个与复发相关的变量（如抑郁）作为因素。入院时存在这些因素的患者出院后的中毒率并不显著高于不存在这些因素的患者。这表明这些双重诊断项目成功地整合了两种障碍的治疗，并解释了其有效性。在第1个月、6个月和12个月时，共病的DSM-IV情绪障碍（如焦虑和抑郁）以及涉及阿片类药物或可卡因的药物滥用情况在66%至95%之间。
