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2012财年至2014年新精神活性物质(NPS)相关障碍患者临床症状的变化:一项在成瘾治疗专科医院的研究。

Changes of clinical symptoms in patients with new psychoactive substance (NPS)-related disorders from fiscal year 2012 to 2014: A study in hospitals specializing in the treatment of addiction.

作者信息

Funada Daisuke, Matsumoto Toshihiko, Tanibuchi Yuko, Kawasoe Yasunari, Sakakibara Satoru, Naruse Nobuya, Ikeda Shunichiro, Sunami Takashi, Muto Takeo, Cho Tetsuji

机构信息

National Center of Neurology and Psychiatry, National Center Hospital, Kodaira, Japan.

National Center of Neurology and Psychiatry, National Institute of Mental Health, Kodaira, Japan.

出版信息

Neuropsychopharmacol Rep. 2019 Jun;39(2):119-129. doi: 10.1002/npr2.12053. Epub 2019 Apr 9.

Abstract

AIMS

The use of new psychoactive substances (NPS) has become increasingly widespread over the last decade, in Japan and internationally. NPS are associated with a range of increasingly serious clinical, public, and social issues. Political measures to ameliorate the effects of NPS in Japan have focused on tightening regulation rather than establishing treatment methods. The current study sought to compare the neuropsychiatric symptoms of patients with NPS-related disorders across several years. We examined patients who attended specialized hospitals for treating addiction, to elucidate the impacts of legal measures to control NPS.

METHODS

Subjects (n = 864) were patients with NPS-related disorders who received medical treatment at eight specialized hospitals for treating addiction in Japan between April 2012 and March 2015. Clinical information was collected retrospectively from medical records.

RESULTS

Among psychiatric symptoms, the ratio of hallucinations/delusions decreased over time across 3 years of study (first year vs second year vs third year: 40.1% vs 30.9% vs 31.7%, P = 0.037). Among neurological symptoms, the ratio of coma/syncope increased over the 3-year period (7.8% vs 11.0% vs 17.0%, P = 0.002), as did the ratio of convulsions (2.8% vs 4.3% vs 9.7%, P = 0.001).

CONCLUSION

The symptoms associated with NPS were primarily psychiatric in the first year, while the prevalence of neurological symptoms increased each year. The risk of death and the severity of symptoms were greater in the third year compared with the first year, as regulation of NPS increased.

摘要

目的

在过去十年中,新型精神活性物质(NPS)在日本及国际上的使用日益广泛。NPS与一系列日益严重的临床、公共和社会问题相关。日本改善NPS影响的政治措施主要集中在加强监管而非建立治疗方法。本研究旨在比较数年间NPS相关障碍患者的神经精神症状。我们对前往专门治疗成瘾的医院就诊的患者进行了检查,以阐明控制NPS的法律措施的影响。

方法

研究对象(n = 864)为2012年4月至2015年3月期间在日本八家专门治疗成瘾的医院接受治疗的NPS相关障碍患者。临床信息通过回顾病历进行收集。

结果

在精神症状方面,幻觉/妄想的比例在3年的研究期间随时间下降(第一年 vs 第二年 vs 第三年:40.1% vs 30.9% vs 31.7%,P = 0.037)。在神经症状方面,昏迷/晕厥的比例在3年期间有所增加(7.8% vs 11.0% vs 17.0%,P = 0.002)、抽搐的比例也增加了(2.8% vs 4.3% vs 9.7%,P = 0.001)。

结论

与NPS相关的症状在第一年主要是精神方面的,而神经症状的患病率逐年增加。与第一年相比,随着对NPS监管的加强,第三年的死亡风险和症状严重程度更高。

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