阿片类药物替代治疗的阿片类药物成瘾者的人格障碍与 HCV 感染的风险。
Personality dysfunction in opiate addicts on opioid substitution treatment and the risk of HCV infection.
机构信息
Clinic for Infectious Diseases, University Clinical Hospital Mostar and Center for Prevention and Outpatient Treatment of Addiction, Mostar, Bosnia and Herzegovina.
Clinic for Psychiatry, University Clinical Center of Republic of Srpska, Banja Luka, Bosnia and Herzegovina.
出版信息
Front Public Health. 2022 Sep 9;10:1009413. doi: 10.3389/fpubh.2022.1009413. eCollection 2022.
BACKGROUND
Impulsivity, affective instability, and neglect of oneself and other people's safety as symptoms of personality dysfunction are associated with risky behaviors regarding the transmission of infectious diseases either sexually or by intravenous drug abuse.
OBJECTIVE
The aim of this study was to analyze the association between hepatitis C virus (HCV) infection and personality dysfunction in opiate addicts on opioid substitution treatment.
METHODS
This was a cross-sectional, observational investigation of patients over 18 years of age who were actively participating in opioid substitution treatment at five centers in Bosnia and Herzegovina. The occurrence of HCV infection was the primary study outcome, and personality functioning, the main independent variable, was assessed using the Severity Indices of Personality Problems (SIPP-118) questionnaire. The association between scores of personality functioning domains items and HCV infection status was determined by binary logistic regression analysis.
RESULTS
Patients on opioid substitution therapy with HCV infection more frequently had personality disorders (OR 2.168, 95% CI 1.161-4.05) and were treated longer than patients without HCV infection (OR 1.076, 95% CI 1.015-1.14). HCV infection was associated with lower self-respect (OR 0.946, 95% CI 0.906-0.988), decreased capacity to have enduring relationships with other people (OR 0.878, 95% CI 0.797-0.966), and lower capability to cooperate with others (OR 0.933, 95%CI 0.888-0.98). On the other hand, except for self-respect, other elements of the Identity Integration domain (enjoyment, purposefulness, stable self-image, and self-reflexive functioning), when more functional, increased the risk of HCV infection.
CONCLUSIONS
Our study demonstrates that opiate addicts on opioid substitution treatment have a higher risk of HCV infection if their personality is dysfunctional, especially in the aspects of self-respect, enduring relationships, and cooperativity. The risk is even higher in addicts who have an established diagnosis of any kind of personality disorder.
背景
冲动、情感不稳定以及忽视自身和他人安全等人格功能障碍的症状与性传播或静脉内药物滥用传染病有关的危险行为有关。
目的
本研究旨在分析接受阿片类药物替代治疗的阿片类药物成瘾者中丙型肝炎病毒（HCV）感染与人格功能障碍之间的关系。
方法
这是一项在波斯尼亚和黑塞哥维那五个中心接受阿片类药物替代治疗的 18 岁以上患者的横断面、观察性研究。HCV 感染的发生是主要的研究结果，而主要的独立变量人格功能使用严重度指数人格问题（SIPP-118）问卷进行评估。通过二元逻辑回归分析确定人格功能域项目评分与 HCV 感染状态之间的关系。
结果
HCV 感染的阿片类药物替代治疗患者更频繁地出现人格障碍（OR 2.168，95%CI 1.161-4.05），并且治疗时间长于未感染 HCV 的患者（OR 1.076，95%CI 1.015-1.14）。HCV 感染与自尊降低（OR 0.946，95%CI 0.906-0.988）、与他人持久关系的能力降低（OR 0.878，95%CI 0.797-0.966）和与他人合作的能力降低（OR 0.933，95%CI 0.888-0.98）相关。另一方面，除了自尊之外，身份整合域的其他元素（享受、目的性、稳定的自我形象和自我反思功能），如果功能更完善，会增加 HCV 感染的风险。
结论
我们的研究表明，接受阿片类药物替代治疗的阿片类药物成瘾者，如果人格功能障碍，尤其是在自尊、持久关系和合作方面，感染 HCV 的风险更高。如果成瘾者被确诊患有任何类型的人格障碍，风险甚至更高。
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