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世界卫生组织(WHO)降低酒精使用障碍和共病焦虑障碍住院患者的风险级别。

World Health Organization (WHO) risk level reductions in inpatients with alcohol use disorder and comorbid anxiety disorders.

机构信息

Department of Psychiatry and Behavioral Sciences, University of Minnesota.

Minneapolis Veterans Affairs.

出版信息

Psychol Addict Behav. 2023 Aug;37(5):713-722. doi: 10.1037/adb0000895. Epub 2022 Dec 8.

Abstract

OBJECTIVE

Studies have demonstrated that reduced drinking without total abstinence is associated with improved outcomes in outpatients with alcohol use disorder (AUD). We sought to examine this question in AUD inpatients who have comorbid anxiety disorders, a common presentation in AUD.

METHOD

This is a secondary analysis of data from a randomized controlled trial for = 241 inpatients with AUD and comorbid anxiety disorders. Change from baseline drinking level was measured at 1-, 4-, and 12-months postdischarge, and psychological and functional outcomes were measured at 4- and 12-months postdischarge. Three groups were compared: abstinent, reduced (reduced drinking by 1-3 World Health Organization drinking risk levels without abstinence), or nonreduced (maintained or increased drinking risk level).

RESULTS

At 1-, 4-, and 12-months posttreatment, most patients reported abstinence (83, 63, and 60%), and 11, 25, and 26% reported drinking at a reduced level. Drinking reductions achieved at 1-month posttreatment were maintained at 12-month posttreatment by 74% of participants. Overall, the abstinent group reported the best psychological and functional outcomes at follow-ups, followed by the reduced group. Few differences were observed between reducers and nonreducers, but reducers reported significantly better alcohol dependence severity and alcohol-related problems than nonreducers.

CONCLUSIONS

Though abstinence was associated with the best outcomes in this abstinence-based treatment sample, we conclude that reduced drinking is also associated with significant improvements in alcohol-related outcomes in inpatients with AUD and comorbid anxiety disorders.At 1-, 4-, and 12-months posttreatment, most patients reported abstinence (83, 63, and 60%), and 11, 25, and 26% reported drinking at a reduced level. Drinking reductions achieved at 1-month posttreatment were maintained at 12-month posttreatment by 74% of participants. Overall, the abstinent group reported the best psychological and functional outcomes at follow-ups, followed by the reduced group. Few differences were observed between reducers and nonreducers, but reducers reported significantly (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

目的

研究表明,对于有酒精使用障碍(AUD)的门诊患者,减少饮酒但不彻底戒酒与改善预后相关。我们旨在探讨 AUD 住院患者中是否存在这种情况,因为共病焦虑障碍是 AUD 的常见表现。

方法

这是一项对 241 例 AUD 合并焦虑障碍住院患者的随机对照试验数据的二次分析。从基线饮酒水平的变化在出院后 1、4 和 12 个月进行测量,在出院后 4 和 12 个月进行心理和功能结局测量。比较了三组:戒酒、减少(在不戒酒的情况下减少 1-3 个世界卫生组织饮酒风险水平)或未减少(维持或增加饮酒风险水平)。

结果

在治疗后 1、4 和 12 个月,大多数患者报告戒酒(83%、63%和 60%),11%、25%和 26%报告饮酒量减少。在治疗后 1 个月时达到的饮酒量减少,在治疗后 12 个月时被 74%的参与者维持。总体而言,在随访中,戒酒组报告的心理和功能结局最好,其次是减少组。减少组和未减少组之间几乎没有差异,但减少组报告的酒精依赖严重程度和与酒精相关问题明显优于未减少组。

结论

尽管在基于戒酒的治疗样本中,戒酒与最佳结局相关,但我们的结论是,对于 AUD 合并焦虑障碍的住院患者,减少饮酒也与酒精相关结局的显著改善相关。在治疗后 1、4 和 12 个月,大多数患者报告戒酒(83%、63%和 60%),11%、25%和 26%报告饮酒量减少。在治疗后 1 个月时达到的饮酒量减少,在治疗后 12 个月时被 74%的参与者维持。总体而言,在随访中,戒酒组报告的心理和功能结局最好,其次是减少组。减少组和未减少组之间几乎没有差异,但减少组报告的酒精依赖严重程度和与酒精相关问题明显优于未减少组。

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