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酒精使用障碍(AUD)患者治疗中震颤谵妄的病史:与AUD严重程度及其他因素的关系

History of Delirium Tremens in AUD Patients in Treatment: Relationship to AUD Severity and Other Factors.

作者信息

Bramness Jørgen G, Pandey Susmita, Moe Jenny Skumsnes, Toft Helge, Lien Lars, Bolstad Ingeborg

机构信息

Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway.

Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Oslo, Norway.

出版信息

Subst Abuse Rehabil. 2022 Sep 13;13:65-72. doi: 10.2147/SAR.S361810. eCollection 2022.

Abstract

INTRODUCTION

Delirium tremens (DT) occurs after stopping prolonged, high alcohol intake and may be life-threatening if untreated. We need to know about clinical correlates of DT in order to provide the best clinical care.

METHODS

At admission to inpatient treatment a cohort of 114 alcohol use disorder (AUD) patients were interviewed and examined concerning psychiatric diagnosis and symptoms, trauma experiences and alcohol related measures and if they had experienced DT.

RESULTS

Twenty-four percent of the patients reported a life-time experience of DT. These patients were predominantly males and had lower educational level. More of the patients in the DT than the non-DT group reported at least one suicide attempt, were diagnosed with PTSD, and dropped out of treatment. Also, having parents with alcohol problems was more common among these patients, and they reported a longer duration of problematic drinking and a higher number of drinks needed to feel an effect of drinking. In the multivariable adjusted analysis only a diagnosis of PTSD (OR=5.71; 95% confidence interval (CI): 1.34-24.31) and duration of problematic drinking with a 6% increase in risk for every year (OR=1.06; 95% CI: 1.01-1.11) remained significant risk factors for having DT experience.

DISCUSSION AND CONCLUSION

Having experienced DT was more prevalent in the current investigation than in earlier studies. Patients that had experienced DT seemed to have more serious AUD, especially signified by a longer duration of drinking. These patients seemed to have many clinical disadvantages including more drop-out and higher suicide rate. PTSD could be a risk factor for DT but may also follow the DT experience.

摘要

引言

震颤谵妄(DT)发生于长期大量饮酒后突然停饮之时,若不治疗可能危及生命。为了提供最佳临床护理,我们需要了解DT的临床相关因素。

方法

114名酒精使用障碍(AUD)患者在入院接受住院治疗时,就精神科诊断与症状、创伤经历、酒精相关指标以及是否经历过DT接受了访谈和检查。

结果

24%的患者报告有过DT的终生经历。这些患者以男性为主,教育水平较低。与未经历DT的组相比,经历DT的患者中更多人报告至少有过一次自杀未遂、被诊断为创伤后应激障碍(PTSD)且退出了治疗。此外,这些患者中父母有酒精问题的情况更为常见,他们报告的问题饮酒持续时间更长,且需要更多饮酒量才能感觉到饮酒的效果。在多变量调整分析中,只有PTSD诊断(比值比[OR]=5.71;95%置信区间[CI]:1.34 - 24.31)以及问题饮酒持续时间(每年风险增加6%,OR=1.06;95%CI:1.01 - 1.11)仍然是有DT经历的显著风险因素。

讨论与结论

在本次调查中,经历DT的情况比早期研究更为普遍。经历过DT的患者似乎有更严重的酒精使用障碍,尤其是以更长的饮酒持续时间为标志。这些患者似乎有许多临床不利因素,包括更多的退出治疗和更高的自杀率。PTSD可能是DT的一个风险因素,但也可能继发于DT经历之后。

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