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基于正念的酒精依赖复发预防:一项随机对照试验的结果

Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial.

作者信息

Zgierska Aleksandra E, Burzinski Cindy A, Mundt Marlon P, McClintock Andrew S, Cox Jennifer, Coe Christopher L, Miller Michael M, Fleming Michael F

机构信息

University of Wisconsin-Madison, School of Medicine and Public Health, Department of Family Medicine and Community Health, 1100 Delaplaine Court, Madison, WI 53715, United States of America.

University of Wisconsin-Madison, Harlow Center for Biological Psychology, 22 N Charter St, Madison, WI 53715, United States of America.

出版信息

J Subst Abuse Treat. 2019 May;100:8-17. doi: 10.1016/j.jsat.2019.01.013. Epub 2019 Jan 17.

Abstract

OBJECTIVES

To assess the effects of mindfulness-based relapse prevention for alcohol dependence (MBRP-A) intervention on drinking and related consequences.

METHODS

123 alcohol-dependent adults in early recovery, recruited from outpatient treatment programs, were randomly assigned to MBRP-A (intervention plus usual-care; N = 64) or Control (usual-care-alone; N = 59) group. MBRP-A consisted of eight-weekly sessions and home practice. Outcomes were assessed at baseline, 8 weeks and 26 weeks (18 weeks post-intervention), and compared between groups using repeated measures analysis.

RESULTS

Outcome analysis included 112 participants (57 MBRP-A; 55 Control) who provided follow-up data. Participants were 41.0 ± 12.2 years old, 56.2% male, and 91% white. Prior to "quit date," they reported drinking on 59.4 ± 34.8% (averaging 6.1 ± 5.0 drinks/day) and heavy drinking (HD) on 50.4 ± 35.5% of days. Their drinking reduced after the "quit date" (before enrollment) to 0.4 ± 1.7% (HD: 0.1 ± 0.7%) of days. At 26 weeks, the MBRP-A and control groups reported any drinking on 11.5 ± 22.5% and 5.9 ± 11.6% of days and HD on 4.5 ± 9.3% and 3.2 ± 8.7% of days, respectively, without between-group differences (ps ≥ 0.05) in drinking or related consequences during the follow-up period. Three MBRP-A participants reported "relapse," defined as three-consecutive HD days, during the study. Subgroup analysis indicated that greater adherence to session attendance and weekly home practice minutes were associated with improved outcomes.

CONCLUSIONS

MBRP-A as an adjunct to usual-care did not show to improve outcomes in alcohol-dependent adults in early recovery compared to usual-care-alone; a return to drinking and relapse to HD were rare in both groups. However, greater adherence to MBRP-A intervention may improve long-term drinking-related outcomes.

摘要

目的

评估基于正念的酒精依赖复发预防干预(MBRP-A)对饮酒及相关后果的影响。

方法

从门诊治疗项目中招募123名处于早期康复阶段的酒精依赖成年人,随机分为MBRP-A组(干预加常规护理;N = 64)或对照组(仅常规护理;N = 59)。MBRP-A包括八次每周一次的课程及家庭练习。在基线、8周和26周(干预后18周)评估结果,并使用重复测量分析在组间进行比较。

结果

结果分析纳入了112名提供随访数据的参与者(57名MBRP-A组;55名对照组)。参与者年龄为41.0±12.2岁,56.2%为男性,91%为白人。在“戒酒日期”之前,他们报告饮酒天数占59.4±34.8%(平均每天饮酒6.1±5.0杯),重度饮酒(HD)天数占50.4±35.5%。在“戒酒日期”(入组前)后,他们的饮酒天数减少至0.4±1.7%(HD:0.1±0.7%)。在26周时,MBRP-A组和对照组报告饮酒天数分别占11.5±22.5%和5.9±11.6%,HD天数分别占4.5±9.3%和3.2±8.7%,随访期间两组在饮酒或相关后果方面无组间差异(p≥0.05)。三名MBRP-A组参与者在研究期间报告了“复发”,定义为连续三天重度饮酒。亚组分析表明,更高的课程出席率和每周家庭练习分钟数与更好的结果相关。

结论

与仅接受常规护理相比,MBRP-A作为常规护理的辅助手段,在处于早期康复阶段的酒精依赖成年人中并未显示出能改善结果;两组中恢复饮酒和复发至重度饮酒的情况都很少见。然而,更高程度地坚持MBRP-A干预可能会改善长期与饮酒相关的结果。

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