Kuwata T, Suwaki H
Department of Neuropsychiatry, Faculty of Medicine, Kagawa Medical University, Japan.
Nihon Arukoru Yakubutsu Igakkai Zasshi. 1998 Oct;33(5):574-86.
The present study was conducted for clarifying the comorbidity of substance dependence and other psychiatric disorders in outpatients of four psychiatric hospitals in May, 1995. The results were as follows; 7.4% (N = 234) of the total 3155 psychiatric outpatients were diagnosed as substance dependence. Among those substance dependence patients, alcohol dependence accounted for 82.5% and the percentage of the other substance dependence were very small, i.e., methamphetamine dependence 6.4%, solvent dependence 1.7%, multiple substance dependence 9.4%, respectively. The percentage of comorbidity of substance dependence and psychiatric disorders was 23.9% (N = 56) of 234 substance dependence patients. The percentage of co-morbid alcohol dependence patients with affective disorder in all affective disorder patients was 5.0%; the percentage of comorbidity of alcohol dependence in neurotic patients 4.1%; the percentage of alcohol dependence comorbidity in schizophrenic patients 0.7%. In many cases, onsets of substance dependence and psychiatric disorders were within 2 years, which suggests the common backgrounds for substance dependence and psychiatric disorders, such as disruption of family and occupational life, stress and individual vulnerability, and substance use for self-medication. The study indicates that the percentages of diagnosed comorbidity of substance dependence and psychiatric disorders are generally smaller in Japan than in the U.S., which may be based on the differences of diagnostic standards between the two countries. Further studies are needed on the comorbidity of substance dependence and psychiatric disorders in other general hospital and psychiatric clinic patients.
本研究旨在明确1995年5月四家精神病院门诊患者中物质依赖与其他精神障碍的共病情况。结果如下：在3155名精神科门诊患者中，7.4%（N = 234）被诊断为物质依赖。在这些物质依赖患者中，酒精依赖占82.5%，其他物质依赖的比例非常小，即甲基苯丙胺依赖6.4%，溶剂依赖1.7%，多种物质依赖9.4%。物质依赖与精神障碍共病的比例在234名物质依赖患者中为23.9%（N = 56）。酒精依赖合并情感障碍的患者在所有情感障碍患者中的比例为5.0%；酒精依赖在神经症患者中的共病比例为4.1%；酒精依赖在精神分裂症患者中的共病比例为0.7%。在许多情况下，物质依赖和精神障碍的发病时间在2年内，这表明物质依赖和精神障碍有共同的背景，如家庭和职业生活的破坏、压力和个体易感性，以及用于自我治疗的物质使用。该研究表明，在日本，物质依赖与精神障碍诊断共病的比例普遍低于美国，这可能基于两国诊断标准的差异。需要对其他综合医院和精神科门诊患者中物质依赖与精神障碍的共病情况进行进一步研究。
