Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
Am J Addict. 2020 Jan;29(1):43-50. doi: 10.1111/ajad.12978. Epub 2019 Nov 6.
Ketamine has emerged as one of the major illicit substances worldwide. Craving, a primary symptom for addiction, is a key challenge for ketamine abusers attempting abstinence. A link between craving and negative affect has been suggested previously for other substances. We examined the relationship between craving and negative effect (depression and anxiety) in patients with ketamine dependence (KD) undergoing withdrawal treatment.
We included 104 patients with KD (76 males and 28 females) who received inpatient treatment for ketamine withdrawal and assessed them by using Beck Depression Inventory (BDI), Beck Anxiety Inventory, and a visual analog scale (VAS; 0-100 mm) for ketamine craving on day 2 to 3 of admission.
Fifty-nine (59%) and 38 (38.7%) of our patients reported moderate-to-severe depression and anxiety symptoms, respectively. Patients with greater cravings (ie, greater than the median VAS) reported spending more days on ketamine in the preceding month and displayed severer depressive symptoms than did those with lower cravings. VAS was significantly correlated with BDI scores after adjustment. Patients who stayed in the treatment longer (more than 2 weeks) experienced more cravings and depressive symptoms than those who did not.
We observed a high prevalence of depression in patients with KD, particularly those with higher cravings. Patients with greater cravings and severer depression might require a longer duration of withdrawal treatment.
This research provides intimal evidence for an association between depression and craving in patients with KD. Screening and management of depression are recommended for this population. (Am J Addict 2019;00:00-00).
氯胺酮已成为全球主要的非法药物之一。成瘾的主要症状之一是渴求，这是试图戒除氯胺酮的滥用者面临的主要挑战。之前有研究表明，其他物质的渴求与负性情绪之间存在关联。我们研究了接受氯胺酮戒断治疗的氯胺酮依赖（KD）患者中渴求与负性效应（抑郁和焦虑）之间的关系。
我们纳入了 104 名 KD 患者（76 名男性和 28 名女性），他们接受了住院治疗以戒除氯胺酮，并在入院后第 2-3 天使用贝克抑郁量表（BDI）、贝克焦虑量表和视觉模拟量表（VAS；0-100mm）评估他们的氯胺酮渴求程度。
59%（59%）和 38%（38.7%）的患者报告有中重度抑郁和焦虑症状。与渴求程度较低的患者相比，渴求程度较高（即 VAS 大于中位数）的患者在前一个月使用氯胺酮的天数更多，且抑郁症状更严重。在调整后，VAS 与 BDI 评分显著相关。住院时间较长（超过 2 周）的患者比未住院的患者有更多的渴求感和抑郁症状。
我们观察到 KD 患者中存在较高的抑郁发生率，尤其是那些渴求程度较高的患者。渴求程度较高和抑郁症状较严重的患者可能需要更长时间的戒断治疗。
本研究为 KD 患者中抑郁与渴求之间的关联提供了初步证据。建议对这一人群进行抑郁筛查和管理。
