Krausz M, Verthein U, Degkwitz P
Klinik für Psychiatrie und Psychotherapie, Universität Hamburg (UKE).
Nervenarzt. 1998 Jul;69(7):557-67. doi: 10.1007/s001150050312.
In the course of a 5-year follow-up study concerning comorbidity in opiate addicts, 350 patients were investigated initially in various addiction centres in Hamburg. More than two thirds of the participants of the study are male, with an average age of 29 years at the time of the investigation. Most of them are receiving methadone maintenance treatment (42%), about one fourth is in residential rehabilitation and another 17% in inpatient detoxification treatment. The patients have been consuming heroin for an average of 9 years. For 55% of the opiate addicts (at least) one more psychic disorder in accordance with ICD-10 has been diagnosed (lifetime prevalence). F6 personality disorders have not been taken into consideration. The 6-month prevalence is 37%, 2-week prevalence 23%. For 43% of the opiate addicts, the predominant disorders belong to the group of neurotic, endurance, and somatoform disorders (F4), and for 32% of the patients to the group of affective disorders (F3). Schizophrenic, schizotypic and delusional disorders (F2) are less frequent (5%). Another 5% of the opiate addicts suffer from eating disorders (F5). These are partly multiple diagnoses cases; there is an average of 1.3 diagnoses per patient. Women are clearly more often affected by comorbidity than men. Most disorders first occur between the age of 18 and 21 years. Therefore, (lifetime) prevalence rates are twice to three times as high as that of the average German population, according to the present state of knowledge. This underlines the great importance of specific diagnostic and explorative methods for the treatment of addiction. Psychic disorders or disturbances that might adversely affect the course of treatment should be given more consideration.
在一项关于阿片类药物成瘾者合并症的5年随访研究过程中，最初在汉堡的各个戒毒中心对350名患者进行了调查。研究参与者中超过三分之二为男性，调查时的平均年龄为29岁。他们中的大多数人正在接受美沙酮维持治疗（42%），约四分之一在住院康复治疗，另有17%在住院戒毒治疗。这些患者平均吸食海洛因9年。根据国际疾病分类第10版（ICD - 10），55%的阿片类药物成瘾者（至少）被诊断出患有另一种精神障碍（终生患病率）。未考虑F6人格障碍。6个月患病率为37%，2周患病率为23%。43%的阿片类药物成瘾者，主要障碍属于神经症、持久性和躯体形式障碍组（F4），32%的患者属于情感障碍组（F3）。精神分裂症、分裂型和妄想性障碍（F2）较少见（5%）。另有5%的阿片类药物成瘾者患有进食障碍（F5）。这些部分是多重诊断病例；每位患者平均有1.3种诊断。女性比男性明显更常受到合并症的影响。大多数障碍首次出现在18岁至21岁之间。因此，根据目前的知识状况，（终生）患病率是德国普通人群的两倍至三倍。这突出了特定诊断和探索方法对成瘾治疗的重要性。应更多考虑可能对治疗过程产生不利影响的精神障碍或干扰。
