重新审视酒精治疗无反应者：治疗三年后重度饮酒者的心理社会功能
Reconsidering alcohol treatment non-responders: psychosocial functioning among heavy drinkers 3 years following treatment.
作者信息
Pearson Matthew R, Wilson Adam D, Richards Dylan K, Witkiewitz Katie
机构信息
Center on Alcohol, Substance use, and Addictions, University of New Mexico, Albuquerque, NM, USA.
Center on Alcohol, Substance use, and Addictions, Department of Psychology, University of New Mexico, Albuquerque, NM, USA.
出版信息
Addiction. 2021 May;116(5):1262-1269. doi: 10.1111/add.15280. Epub 2020 Dec 18.
BACKGROUND AND AIMS
Psychosocial functioning among individuals who exceed low-risk drinking limits (exceed three to four standard drinks for women/men) is heterogeneous. Among those who receive treatment for alcohol use disorder (AUD), recent research found that more than one-half of those who exceeded low-risk limits (i.e. treatment non-responders) reported good psychosocial functioning, commensurate with those who were abstinent or low-risk drinkers (i.e. treatment responders) up to 1 year following treatment. This study aimed to determine if good levels of psychosocial functioning are maintained beyond 1 year.
DESIGN
Secondary analysis of 3-year follow-up data from Project MATCH (Matching Alcoholism Treatment to Client Heterogeneity) and the Combined Pharmacotherapies and Behavioral Interventions study (COMBINE), multi-site alcohol clinical trials conducted in the United States.
SETTING
Eleven sites in COMBINE and nine sites in Project MATCH.
PARTICIPANTS
Individuals with AUD from COMBINE and Project MATCH (n = 1383 and n = 1726) characterized in terms of drinking/functioning at 1-year follow-up and retained at 3-year (n = 641 and n = 790) post-treatment follow-ups.
MEASUREMENTS
Alcohol consumption measured by Form-90 and psychosocial functioning assessed by various instruments at 3 years post-treatment FINDINGS: High-functioning non-responders at 1 year post-treatment maintained a high level of functioning 2 years later and were not significantly different from the abstainers/low-risk drinkers on any functional outcomes (e.g. SF12 Mental Health Mean difference: -1.38 [95% confidence interval (CI) = -4.34, 1.57), SF12 Physical Health Mean difference: -0.43 (95% CI = -2.28, 3.13)].
CONCLUSIONS
Approximately one-half of those who engage in some heavy drinking in the year following treatment for alcohol use disorder appear to maintain high levels of psychosocial functioning up to 3 years following treatment.
背景与目的
饮酒量超过低风险限度（女性/男性超过三到四个标准饮酒单位）的个体，其心理社会功能存在异质性。在接受酒精使用障碍（AUD）治疗的人群中，近期研究发现，超过低风险限度的人群（即治疗无反应者）中有超过一半报告称心理社会功能良好，在治疗后长达1年的时间里，与戒酒者或低风险饮酒者（即治疗有反应者）相当。本研究旨在确定心理社会功能的良好水平在1年后是否能得以维持。
设计
对来自美国多中心酒精临床试验“匹配酒精成瘾治疗与患者异质性项目”（Project MATCH）和“联合药物治疗与行为干预研究”（COMBINE）的3年随访数据进行二次分析。
地点
COMBINE研究中的11个地点以及Project MATCH研究中的9个地点。
参与者
来自COMBINE研究和Project MATCH研究的AUD患者（分别为n = 1383和n = 1726），在1年随访时根据饮酒/功能情况进行了特征描述，并在治疗后3年随访时仍被纳入研究（分别为n = 641和n = 790）。
测量
治疗后3年时，通过Form - 90测量酒精摄入量，并使用多种工具评估心理社会功能。
结果
治疗后1年时功能良好的无反应者在2年后仍维持较高功能水平，在任何功能结局方面与戒酒者/低风险饮酒者均无显著差异（例如，SF12心理健康平均差异：-1.38 [95%置信区间（CI）= -4.34, 1.57]，SF12身体健康平均差异：-0.43 [95% CI = -2.28, 3.13]）。
结论
在酒精使用障碍治疗后的一年内有过一定程度重度饮酒的人群中，约有一半在治疗后长达3年的时间里似乎能维持较高的心理社会功能水平。
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