Kidorf Michael, Solazzo Stephanie, Yan Haijuan, Brooner Robert K
a Department of Psychiatry and Behavioral Sciences, Addiction Treatment Services-BBRC, Johns Hopkins Bayview Medical Center , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
J Dual Diagn. 2018 Oct-Dec;14(4):193-200. doi: 10.1080/15504263.2018.1510148. Epub 2018 Oct 17.
The present study evaluated rates of co-occurring current psychiatric and substance use disorders in a sample of opioid-dependent treatment-seeking injection drug users referred from syringe exchange.
Participants (N = 208) completed the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV-R to assess current (within the past year) psychiatric and substance use disorders and the two most commonly diagnosed personality disorders (antisocial and borderline personality disorders).
Forty-eight percent of the sample had a current Axis I psychiatric disorder, and 67% had a co-occurring current substance use disorder. Posttraumatic stress disorder (21%), major depression (17%), and bipolar I (12%) were the most prevalent Axis I psychiatric disorders, and cocaine use disorder (53%) was the most commonly co-occurring substance use disorder. Women were more likely to have diagnoses of most anxiety disorders and less likely to have diagnoses of alcohol use disorder or antisocial personality disorder. The presence of a personality disorder was associated with higher rates of cocaine and sedative use disorder.
Findings suggest the importance of evaluating and treating co-occurring psychiatric and substance use disorders in the treatment of injection drug users with opioid dependence.
本研究评估了从针头交换项目转介而来的寻求阿片类药物依赖治疗的注射吸毒者样本中同时存在的当前精神疾病和物质使用障碍的发生率。
参与者（N = 208）完成了《精神疾病诊断与统计手册》（DSM）第四版修订版的结构化临床访谈，以评估当前（过去一年内）的精神疾病和物质使用障碍以及两种最常诊断的人格障碍（反社会和边缘型人格障碍）。
48%的样本患有当前的轴I精神疾病，67%同时患有当前的物质使用障碍。创伤后应激障碍（21%）、重度抑郁症（17%）和双相I型障碍（12%）是最常见的轴I精神疾病，可卡因使用障碍（53%）是最常见的同时存在的物质使用障碍。女性更有可能被诊断患有大多数焦虑症，而被诊断患有酒精使用障碍或反社会人格障碍的可能性较小。人格障碍的存在与可卡因和镇静剂使用障碍的较高发生率相关。
研究结果表明，在治疗阿片类药物依赖的注射吸毒者时，评估和治疗同时存在的精神疾病和物质使用障碍具有重要意义。
