Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway.
Department of Substance Abuse Treatment, Clinic of Mental Health and Substance Abuse Treatment, Møre and Romsdal Hospital Trust, Ålesund, Norway.
Addict Behav. 2019 Mar;90:222-228. doi: 10.1016/j.addbeh.2018.11.008. Epub 2018 Nov 11.
The main aim was to investigate the relative roles of mental distress and intrinsic motivation for relapse after inpatient substance use disorder (SUD) treatment, while adjusting for demographics and treatment variables.
The study is based on a prospective multicenter study with a baseline gross sample of 607 patients with SUD (response rate = 84%) admitted to an inpatient stay at one of five specialized SUD treatment centers in Norway. The analytical sample consisted of patients with illicit drug use (n = 374) who took part in a follow-up interview three months after discharge from inpatient treatment (n = 249) (retention rate = 67%). Data were collected using information from electronic medical records, a self-report questionnaire at treatment entry, and a follow-up interview.
Relapse occurred among 37% of the sample by three-month follow-up. Results of multivariable analysis showed that younger age and having a psychiatric diagnosis were associated with an elevated relapse risk. Patients who received treatment at a short-term clinic (2-4 months), as opposed to a long-term clinic (>6 months) were also at increased risk of relapse, regardless of their length of stay. Reduced risk of relapse was predicted by having completed the inpatient treatment stay.
Identifying the treatment needs of young patients and patients with co-occurring psychiatric diagnoses during and following inpatient SUD treatment may contribute to reduced post-treatment relapse rates. Further research is needed to illuminate the treatment-related factors that contribute to reduced risk of relapse after inpatient SUD treatment.
本研究旨在调查精神困扰和内在动机对住院物质使用障碍(SUD)治疗后复吸的相对作用,同时调整人口统计学和治疗变量。
本研究基于一项前瞻性多中心研究,基线总样本为 607 名 SUD 患者(应答率为 84%),他们在挪威的 5 家专门的 SUD 治疗中心之一接受住院治疗。分析样本包括使用非法药物的患者(n=374),他们在出院后三个月参加了随访访谈(n=249)(保留率为 67%)。数据通过电子病历、治疗开始时的自我报告问卷和随访访谈收集。
在三个月的随访中,37%的样本出现了复吸。多变量分析结果显示,年龄较小和有精神科诊断与复吸风险增加有关。与长期诊所(>6 个月)相比,在短期诊所(2-4 个月)接受治疗的患者无论住院时间长短,复吸风险也增加。完成住院治疗与降低复吸风险相关。
在住院 SUD 治疗期间和之后识别年轻患者和共病精神科诊断患者的治疗需求,可能有助于降低治疗后复吸率。需要进一步研究阐明与住院 SUD 治疗后降低复吸风险相关的治疗因素。