O'Brien C P, Woody G E, McLellan A T
J Clin Psychiatry. 1984 Dec;45(12 Pt 2):9-13.
An examination of substance abusers in contemporary practice reveals a high frequency of psychiatric disorders. In some cases, these probably represent preexisting conditions, but in others the disorder may be initiated or aggravated by the biologic and social consequences of substance abuse. The severity of a patient's psychiatric disorder is predictive of response to substance abuse treatment. A high proportion of affective disorders has been found among opioid-dependent patients; these are responsive to psychotherapy and to antidepressant treatment with doxepin. Careful psychiatric diagnosis in the management of substance abuse can discriminate those patients who are likely to require psychotherapy or psychoactive medication from those who may do well with standard drug counseling alone.
对当代实际中的药物滥用者进行检查发现，精神障碍的发生率很高。在某些情况下，这些可能代表先前就存在的病症，但在其他情况下，该障碍可能由药物滥用的生物学和社会后果引发或加重。患者精神障碍的严重程度可预测对药物滥用治疗的反应。在阿片类药物依赖患者中发现了高比例的情感障碍；这些对心理治疗和用多塞平进行的抗抑郁治疗有反应。在药物滥用管理中进行仔细的精神科诊断，可以区分出那些可能需要心理治疗或精神活性药物的患者与那些仅通过标准药物咨询可能就会好转的患者。
