Kokkevi A, Stefanis N, Anastasopoulou E, Kostogianni C
Department of Psychiatry, Athens University Medical School, Eginition Hospital, Greece.
Addict Behav. 1998 Nov-Dec;23(6):841-53.
A sample of 226 drug-dependent individuals consecutively admitted to treatment in the major therapeutic programmes in Greece were assessed at intake with the EuropASI and SCL-90-R. At 4 to 6 weeks, 173 who were continuing treatment were reassessed with the SCL-90-R and interviewed with the SCID-R and the CIDI. Mean age of the subjects was 28 years, and 82.3% were male. Heroin was the main substance of abuse for the large majority (89.8%). Prevalence of AXIS II personality disorders (PD) was 59.5% and the majority (61.2%) had more than one PD. Cluster B was diagnosed in almost half of the subjects (48.6%), Antisocial Personality Disorder (APD) being the most prevalent (33.5%) type of PD. Subjects with APD had an earlier age of initiation of illicit drug use than those without. Subjects with a PD had twice the odds of having a comorbid AXIS I diagnosis and three times the odds of having a mood disorder than those without a PD. SCL-90-R assessments showed that psychiatric symptoms were significantly reduced in the period between intake and the fourth week in treatment. Somatization, Depression and Anxiety symptoms were however less reduced in subjects with a PD than in those without PD. Dropping out from treatment was more strongly predicted by AXIS I than AXIS II disorders, with an increased probability of dropping out in the presence of current mood disorders, whereas current anxiety disorder predicted treatment retention.
对希腊主要治疗项目中连续收治的226名药物依赖个体在入院时用欧洲成瘾严重程度指数（EuropASI）和症状自评量表（SCL-90-R）进行评估。在4至6周时，对173名继续接受治疗的个体再次用SCL-90-R进行评估，并采用研究用诊断访谈表修订版（SCID-R）和复合性国际诊断交谈检查表（CIDI）进行访谈。受试者的平均年龄为28岁，82.3%为男性。海洛因是绝大多数人（89.8%）滥用的主要物质。轴II型人格障碍（PD）的患病率为59.5%，大多数人（61.2%）患有不止一种人格障碍。近一半的受试者（48.6%）被诊断为B类人格障碍，其中反社会人格障碍（APD）是最常见的（33.5%）人格障碍类型。患有反社会人格障碍的受试者开始非法使用毒品的年龄比未患该障碍的受试者更早。患有某种人格障碍的受试者出现共病轴I诊断的几率是未患该障碍者的两倍，出现情绪障碍的几率是未患该障碍者的三倍。SCL-90-R评估显示，在入院至治疗第四周期间，精神症状显著减轻。然而，患有某种人格障碍的受试者的躯体化、抑郁和焦虑症状的减轻程度低于未患该障碍的受试者。与轴II型障碍相比，轴I型障碍更能有力地预测治疗中断，当前存在情绪障碍时治疗中断的可能性增加，而当前的焦虑障碍则预示着治疗持续。
