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[物质使用家族史对成瘾住院患者药物依赖康复治疗准备情况的重要负面影响]

[An essential negative effect of a family history of substance use on readiness for drug dependence rehabilitation treatment in inpatients with addictions].

作者信息

Kibitov A O, Babicheva L P, Chuprova N A, Shchurina A V, Romashkin R A

机构信息

Serbsky National Medical Research Center for Psychiatry and Narcology, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(2):65-73. doi: 10.17116/jnevro20181182165-73.

Abstract

AIM

To reveal objective factors predicting the readiness of inpatient drug treatment patients to undergo a rehabilitation program.

MATERIAL AND METHODS

In a retrospective comparative study, drug-dependent individuals (n=199, 16.6% females, 83.4% men, 91.5% opioid-dependent) were studied. After conducting motivational activities based on cognitive-behavioral psychotherapy, the premorbid, anamnestic, clinical, socio-demographic characteristics of patients were studied as possible predictors of readiness for rehabilitation using binary logistic regression.

RESULTS

Family history of substance use reduced the probability of readiness for rehabilitation by >4,5 times (p<0.0001, Exp (B) = 4.577, CI 95% [2.0556, 10.190]). The influence of other factors was weaker and manifested itself only with their combinations (female sex + use of several psychoactive drugs; intravenous drug injection + polydrug addiction; non-remission course of disease + family history of substance use) which increased the likelihood of readiness for rehabilitation. There was no effect of social/demographic variables.

CONCLUSION

Family history of substance use significantly reduces the likelihood of readiness for rehabilitation. The clinical severity of the disease, on the other hand, increases the chances of readiness. Patients with a family history of substance use represent a specific group of patients requiring maximum efforts in the process of motivation for rehabilitation.

摘要

目的

揭示预测住院药物治疗患者接受康复计划准备程度的客观因素。

材料与方法

在一项回顾性比较研究中,对药物依赖个体(n = 199,女性占16.6%,男性占83.4%,阿片类药物依赖者占91.5%)进行了研究。在开展基于认知行为心理治疗的动机活动后,使用二元逻辑回归分析患者的病前、既往史、临床和社会人口学特征,将其作为康复准备程度的可能预测因素。

结果

物质使用家族史使康复准备程度的概率降低超过4.5倍(p < 0.0001,Exp(B) = 4.577,95%置信区间[2.0556, 10.190])。其他因素的影响较弱,仅在它们组合时表现出来(女性 + 使用多种精神活性药物;静脉注射毒品 + 多药成瘾;疾病未缓解病程 + 物质使用家族史),这些组合增加了康复准备程度的可能性。社会/人口学变量没有影响。

结论

物质使用家族史显著降低康复准备程度的可能性。另一方面,疾病的临床严重程度增加了康复准备的机会。有物质使用家族史的患者是一组特殊的患者群体,在康复动机激发过程中需要付出最大努力。

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