Rounsaville B J, Kosten T R, Weissman M M, Kleber H D
Arch Gen Psychiatry. 1986 Aug;43(8):739-45. doi: 10.1001/archpsyc.1986.01800080025004.
Two different methods for assessing psychopathology in opiate addicts were compared as predictors of long-term treatment outcome: (1) categorical psychiatric diagnosis using the Schedule for Affective Disorders and Schizophrenia--Lifetime Version and the Research Diagnostic Criteria and (2) global rating of psychiatric impairment using the Psychiatric Severity scale of the Addiction Severity Index (ASI). Follow-up interviews were completed 2.5 years after treatment seeking in 76% of a sample of 361 opiate addicts. Five dimensions of treatment outcome were assessed, including current functioning, psychosocial adjustment, substance use impairment, legal problems, and medical disability. Most lifetime psychiatric disorders with a prevalence of greater than 10% were significantly related to the outcome dimensions of current functioning and/or psychosocial adjustment and were unrelated to substance use impairment, legal problems, and medical disability. The ASI Psychiatric Severity rating more robustly predicted poorer functioning in the same two areas and less severe legal problems. While controlling for ASI Psychiatric Severity, the only Research Diagnostic Criteria diagnosis that remained significantly related to treatment outcome was major depression, suggesting that, as regards their prognostic characteristics, the other diagnoses are accounted for by a global underlying severity dimension.
比较了两种评估阿片类成瘾者精神病理学的不同方法，以此作为长期治疗结果的预测指标：（1）使用《情感障碍与精神分裂症量表——终生版》和《研究诊断标准》进行分类精神科诊断；（2）使用《成瘾严重程度指数》（ASI）的精神科严重程度量表对精神损害进行整体评分。在361名阿片类成瘾者样本中，76%的人在寻求治疗2.5年后完成了随访访谈。评估了治疗结果的五个维度，包括当前功能、心理社会适应、物质使用损害、法律问题和医疗残疾。大多数患病率超过10%的终生精神障碍与当前功能和/或心理社会适应的结果维度显著相关，与物质使用损害、法律问题和医疗残疾无关。ASI精神科严重程度评分更有力地预测了在相同两个领域中较差的功能以及不太严重的法律问题。在控制ASI精神科严重程度的情况下，唯一与治疗结果仍显著相关的《研究诊断标准》诊断是重度抑郁症，这表明，就其预后特征而言，其他诊断可由一个整体潜在严重程度维度来解释。
