Baudin Grégoire, Barrault Servane, El Ayoubi Hussein, Kazour François, Ballon Nicolas, Maugé Damien, Hingray Coraline, Brunault Paul, El-Hage Wissam
Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100 Boulogne Billancourt, France.
QualiPsy, EE 1901, Université de Tours, F-37000 Tours, France.
Brain Sci. 2022 Nov 1;12(11):1483. doi: 10.3390/brainsci12111483.
This study aimed to determine whether dissociative symptoms and childhood trauma (CT) may help identify a specific subgroup of patients among those hospitalized for alcohol use disorder (AUD). We assessed 587 patients hospitalized for an AUD in a French addiction rehabilitation center (cross-sectional study) regarding dissociative symptoms (DES-taxon), childhood trauma (CTQ), depression (BDI), anxiety (STAI-state and STAI-trait), posttraumatic stress disorder (PTSD; PCL-5), and AUD symptoms (AUDIT). We ran a hierarchical cluster analysis and compared the clusters in terms of dissociation and CT, as well as AUD, depressive, anxiety, and PTSD symptoms. We identified three clusters of patients: (1) patients with low AUD severity and low dissociation (LALD); (2) patients with high AUD severity and low dissociation (HALD); (3) patients with high AUD severity and high dissociation (HAHD). Patients from the HAHD group had significantly higher dissociation and more severe depression, anxiety, and PTSD symptoms than those with LALD and HALD. They also reported more emotional and sexual abuse than those with LALD. Among patients with an AUD, those with high dissociation may constitute an independent subgroup that exhibits a higher prevalence for CT and higher AUD severity, as well as higher depression, anxiety, and PTSD symptoms. Patients with more severe AUD and associated psychiatric symptoms should be systematically screened for dissociation and provided with tailor-based treatments.
本研究旨在确定分离症状和童年创伤(CT)是否有助于在因酒精使用障碍(AUD)住院的患者中识别出特定的亚组。我们在一家法国成瘾康复中心对587名因AUD住院的患者(横断面研究)进行了评估,内容包括分离症状(解离经验量表分类)、童年创伤(儿童创伤问卷)、抑郁(贝克抑郁量表)、焦虑(状态-特质焦虑量表)、创伤后应激障碍(PTSD;创伤后应激障碍检查表-5)和AUD症状(酒精使用障碍识别测试)。我们进行了层次聚类分析,并比较了各聚类在分离和CT方面以及AUD、抑郁、焦虑和PTSD症状方面的情况。我们识别出三组患者:(1)AUD严重程度低且分离程度低的患者(低AUD严重程度和低分离组);(2)AUD严重程度高且分离程度低的患者(高AUD严重程度和低分离组);(3)AUD严重程度高且分离程度高的患者(高AUD严重程度和高分离组)。与低AUD严重程度和低分离组以及高AUD严重程度和低分离组的患者相比,高AUD严重程度和高分离组的患者有显著更高的分离程度以及更严重的抑郁、焦虑和PTSD症状。他们报告的情感虐待和性虐待也比低AUD严重程度和低分离组的患者更多。在患有AUD的患者中,分离程度高的患者可能构成一个独立的亚组,其CT患病率更高、AUD严重程度更高,以及抑郁、焦虑和PTSD症状更严重。对于AUD更严重且伴有精神症状的患者,应系统筛查其分离症状并给予针对性治疗。