一项关于辩证行为疗法（DBT）减少大麻使用障碍患者的渴求并实现戒断的初步随机对照试验：可行性、可接受性和适宜性。
A pilot randomized controlled trial of dialectical behavior therapy (DBT) for reducing craving and achieving cessation in patients with marijuana use disorder: feasibility, acceptability, and appropriateness.
机构信息
Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
出版信息
Trends Psychiatry Psychother. 2021 Oct-Dec;43(4):302-310. doi: 10.47626/2237-6089-2020-0123. Epub 2021 Apr 2.
OBJECTIVE
To conduct a pilot RCT investigating the feasibility, acceptability, and preliminary efficacy of dialectical behavioral therapy (DBT) for marijuana cessation and craving reduction.
METHODS
Sixty-one patients with marijuana use disorder diagnoses were randomly assigned to a DBT group or a control group (psycho-education). Patients completed measures at pre-intervention, post-intervention, and at two-month follow-up. The Marijuana Craving Questionnaire (MCQ) and marijuana urine test kits were used to assess craving and abstinence respectively.
RESULTS
The feasibility of DBT was significantly higher than control group feasibility. In the DBT 29/30 participants completed all sessions (96% retention) and 24/31 control group participants completed all sessions (77% retention) (χ2 = 4.95, p = 0.02). Moreover, 29/30 (96%) participants in the DBT group completed the two-month follow-up and 20/31 (64.5%) control group members completed the two-month follow-up (χ2 = 9.97, p = 0.002). The results showed that patients in the DBT group had significantly higher intervention acceptability rates (16.57 vs. 9.6) than those in the control group. This pattern was repeated for appropriateness rates (p < 0.05). The overall results for craving showed that there was no significant difference between the groups (F = 3.52, p > 0.05), although DBT showed a significant reduction in the "emotionality" subscale compared to the control group (F = 19.94, p < 0.05). To analyze cessation rates, DBT was compared to the control group at the posttest (46% vs. 16%) and follow-up (40% vs. 9.5%) and the results confirmed higher effectiveness in the DBT group for cessation (p < 0.05). Furthermore, among those who had lapsed, participants in the DBT group had fewer consumption days than those in the control group (p < 0.05).
CONCLUSIONS
DBT showed feasibility, acceptability, and promising efficacy in terms of the marijuana cessation rate.
CLINICAL TRIAL REGISTRATION
Thailand Registry of Clinical Trials, TCTR20200319007.
目的
进行一项初步随机对照试验（RCT），以调查辩证行为疗法（DBT）在戒大麻和减少成瘾方面的可行性、可接受性和初步疗效。
方法
61 名大麻使用障碍诊断患者被随机分配到 DBT 组或对照组（心理教育）。患者在干预前、干预后和两个月随访时完成了测量。大麻渴望问卷（MCQ）和大麻尿液检测试剂盒分别用于评估渴望和禁欲。
结果
DBT 的可行性明显高于对照组的可行性。在 DBT 中，30 名参与者中有 29 名（96%）完成了所有课程（保留率），而对照组 31 名参与者中有 24 名（77%）完成了所有课程（χ2 = 4.95，p = 0.02）。此外，DBT 组 30 名（96%）参与者完成了两个月随访，而对照组 31 名成员中有 20 名（64.5%）完成了两个月随访（χ2 = 9.97，p = 0.002）。结果表明，DBT 组的患者接受率明显高于对照组（16.57%比 9.6%）。这种模式也适用于适当率（p<0.05）。总体渴望结果显示，两组之间没有显著差异（F=3.52，p>0.05），尽管 DBT 组与对照组相比，“情感”亚量表显著降低（F=19.94，p<0.05）。为了分析戒烟率，将 DBT 与对照组在测试后（46%比 16%）和随访（40%比 9.5%）进行比较，结果证实 DBT 组在戒烟方面更有效（p<0.05）。此外，在那些复发的参与者中，DBT 组的参与者的消费天数比对照组少（p<0.05）。
结论
DBT 在大麻戒断率方面显示出可行性、可接受性和有希望的疗效。
临床试验注册
泰国临床试验注册处，TCTR20200319007。
Zotero 插件