Department of Psychiatry, Rhode Island Hospital, United States; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States.
Stonehill College, United States.
Curr Opin Psychol. 2019 Dec;30:17-23. doi: 10.1016/j.copsyc.2018.12.020. Epub 2019 Jan 4.
Opioid use disorder and anxiety disorders co-occur at strikingly high rates, and this comorbidity is marked by a more severe clinical presentation and poorer prognosis for treatment. Given the substantial morbidity and mortality associated with these two disorders, it is imperative to understand factors related to the high rates of co-occurrence in order to inform the development of specialized treatments for this population. Several lines of study suggest that simultaneously addressing opioid-related and anxiety-related symptoms and processes, particularly intolerance of distress and pain-related anxiety, may yield improved outcomes for this high risk, vulnerable population. Future work is needed to identify other novel mechanisms as well as develop specialized treatments to augment standard medication-assisted treatment.
阿片类药物使用障碍和焦虑障碍的共病率极高，这种共病的临床表现更严重，治疗预后更差。鉴于这两种疾病与大量的发病率和死亡率相关，了解与共病率高相关的因素对于为这一人群制定专门的治疗方法至关重要。几项研究表明，同时解决与阿片类药物相关的和与焦虑相关的症状和过程，特别是对痛苦和与疼痛相关的焦虑的不耐受，可能会为这一高风险、脆弱的人群带来更好的结果。未来需要开展更多的工作来确定其他新的机制，并开发专门的治疗方法来增强标准的药物辅助治疗。
