Sureshkumar Kailash, Dalal Pranab Kumar, Kailash Shabeeba Z, Rudhran Vidyendaran
Department of Psychiatry, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India.
Department of Psychiatry, King George Medical University, Lucknow, Uttar Pradesh, India.
Indian J Psychiatry. 2021 Jul-Aug;63(4):372-376. doi: 10.4103/psychiatry.IndianJPsychiatry_383_20. Epub 2021 Aug 7.
Although our understanding about neurobiology of opioid dependence and availability of pharmacological treatment has gone a long way in the last few decades, psychosocial interventions play a pivotal role in the prevention of relapse owing to reasons such as less treatment-seeking behavior and poor penetrance of opioid substitution treatment. There are many studies assessing psychosocial factors in alcohol and nicotine dependence, yet the availability of such studies for opioid dependence is sparse. This study aimed at evaluating the association of relapse in opioid dependence with various psychosocial factors.
This was a cross-sectional study with two groups of opioid dependence patients: In abstinence ( = 28) and relapse ( = 33). Psychosocial variables such as high-risk situations, coping behavior, stressful life events, self-efficacy, and social support were assessed in the two groups and analyzed for the association with opioid relapse.
This study reports that more high risk situations (odds ratio [OR] =1.58; 95% confidence interval [CI] =1.22-2.03; = 0.017), especially negative mood state and undesirable stressful life events (OR = 2.08; 95% CI = 1.28-3.37; = 0.05) were significantly associated with higher odds of relapse in patients of opioid dependence. Further, higher self-efficacy (OR = 0.92; 95% CI = 0.87-0.96; = 0.017) was significantly associated with lower odds of relapse.
Psychosocial factors such as high risk situations, undesirable stressful life events, and self-efficacy were significantly associated with relapse in opioid dependence. Hence, practice of a holistic, multimodal, and individualized treatment plan addressing these factors might help in reducing the relapse rates in them.
尽管在过去几十年里，我们对阿片类药物依赖的神经生物学的理解以及药物治疗的可用性有了长足的进步，但由于诸如寻求治疗行为较少和阿片类药物替代治疗的渗透率较低等原因，心理社会干预在预防复发方面起着关键作用。有许多研究评估了酒精和尼古丁依赖中的心理社会因素，但针对阿片类药物依赖的此类研究却很少。本研究旨在评估阿片类药物依赖复发与各种心理社会因素之间的关联。
这是一项横断面研究，有两组阿片类药物依赖患者：戒断组（n = 28）和复发组（n = 33）。对两组患者评估了高风险情境、应对行为、应激性生活事件、自我效能感和社会支持等心理社会变量，并分析了它们与阿片类药物复发的关联。
本研究报告称，更多的高风险情境（优势比[OR]=1.58；95%置信区间[CI]=1.22 - 2.03；P = 0.017），尤其是消极情绪状态和不良应激性生活事件（OR = 2.08；95% CI = 1.28 - 3.37；P = 0.05）与阿片类药物依赖患者更高的复发几率显著相关。此外，更高的自我效能感（OR = 0.92；95% CI = 0.87 - 0.96；P = 0.017）与更低的复发几率显著相关。
高风险情境、不良应激性生活事件和自我效能感等心理社会因素与阿片类药物依赖的复发显著相关。因此，实施针对这些因素的全面、多模式和个体化治疗方案可能有助于降低他们的复发率。
