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海洛因依赖者戒毒回归社会后一年转归情况随访研究 被引量：2

A 1-year follow-up study on the drug use pattern of heroin addicts who return to society after detoxification
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摘要 目的了解海洛因依赖者戒毒回归社会后1年内药物滥用的结局与转归，分析海洛因依赖者戒断后1年复吸的预后因素。方法使用自制个案调查表、应激感觉量表（PSS）和成瘾行为严重度指数量表（ASI）对563例回归社会后1年的海洛因依赖者进行访谈评估，并使用自然病程问卷（NHI）跟踪随访1年内复吸发生情况，对操守时间进行生存分析。结果共249例完成1年随访面谈，其中发生复吸者为111例（44．6％），平均操守时间为（8．3±0．3）个月；复吸者心理渴求程度[（3．69±3．60）分：（0．40±1．46）分；P〈0．01]、PSS评分[（19．0±4．7）分：（17．6±4．6）分；P〈0．05]及ASI的躯体状况[0．00（0．00—0．33）分：0．00（0．00～0．02）分；P〈0．01]、就业状况[（0．83±0．27）分：（0．67±0．30）分；P〈0．01]、毒品使用状况[0．14（0．00～0．25）分：0．00（0．130～0．00）分；P〈0．01]、酒精滥用情况[0．00（0．00～0．08）分：0．00（0．00～0．00）分；P〈0．05]、法律状况[（0．00（0．00～0．05）分：0．00（0．00～0．00）分；P〈0．01]、家庭支持[0．13（0．04～0．26）分：0．10（0．00～0．18）分；P〈0．01]和精神状况[0．00（0．09—0．36）分：0．00（0．00—0．00）分；P〈0．01]因子分均高于操守者；Cox回归分析显示，基线心理渴求程度是复吸的危险因素（OR=1．226，P〈0．01）。结论海洛因依赖者戒毒后回归社会后1年内发生复吸行为比例高，有无发生复吸的海洛因依赖者具有不同的临床特征，降低毒品的心理渴求程度可降低回归社会后复吸的风险。 Objective To examine the drug use pattern of detoxificated heroin addicts after 1 year from return to society after detoxifieation, and to identify predictors of relapse. Methods 563 heroin addicts were accessed by case questionnaire and the Perceived Stress Scall（ PPS）, Addiction Severity Index （ASI）, and followed after 1 year by the Nature History Interview （NHI） from return to society after detoxification. ＂Relapse＂ was defined as any heroin use during 1 year after detoxification. Survival analysis were used to examine the drug use pattern and to identify the predictor of relapse. Results There were 111 cases （44. 6% ） had heroin use during observation period among 249 cases who completee 1 year follow-up. Survival analysis showed that the average maintaining abstinence time was （ 8. 3 -±0. 3 ） months. Relapsed and non-relapsed addicts presented different craving degree （ 3.69± 3.60 vs. 0. 40 ±1.46, P 〈 0. 01 ） , PSS scores （ 19. 0 ± 4. 7 vs. 17.6±4. 6, P 〈 0.05 ） , physical condition dimension score [ 0.00 （0. 00 - 0. 33 ） vs. 0. 00（0.00（0. 00 -0.02） , P 〈0. 01 ] , employment dimension score （0.83 ±0.27 vs. 0. 67 ±0. 30, P 〈 0. 01 ）, alcohol problem dimension score [ 0. 00 （0. 00 -0. 08 ） vs. 0.00 （0. 00 - 0. 00） ], P 〈 0. 05 ], drug problem dimension score [0.14 ＋ （0.00-0.25） vs. 0.00 （0.00-0.00） , P 〈0.01], legal problems dimension score [0. 00 （ 0. 00 - 0. 05 ） vs.0. 00 （ 0. 00 - 0.00 ）, P 〈 0. 01 ], family status dimension score [0. 13（0. 04 -0. 26） vs. O. 10（0. O0 -0. 18）, P 〈0. 01 ], mental health dimension score [0. 09（0.00 -0. 36） vs. 0. 00（0. 00 -0. 00）, P 〈0. 01 ] at follow-up interview. Cox regression analysis results showed that the craving degree during the past one month at baseline was a risk factor related to relapse （ OR = 1. 226, P 〈 0. 01 ）. Conclusion The proportion of detoxificated heroin addicts during 1 year from return to society occur relapse is higher, and relapsed heroin addicts probably present different clinical characteristics in camparison with non-relapsed ones.
作者 江海峰 李质彬 杜江 潘淑均 陈红 钟娜 赵敏
机构地区 上海交通大学医学院附属精神卫生中心
出处 《中华精神科杂志》 CAS CSCD 北大核心 2013年第1期18-22,共5页 Chinese Journal of Psychiatry
基金 上海市禁毒基金项目，国家科技部"十一五"支撑计划，国家自然科学基金
关键词 海洛因依赖者 随访研究 复发 存活率分析 Heroin dependence Follow-up studies Relapse Survival analysis
分类号 R749.64 [医药卫生—神经病学与精神病学]
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参考文献17

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中华精神科杂志
2013年 第1期

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