海洛因依赖者与精神障碍的共病分析

Comorbidity Analysis among Heroin Dependent Patients

目的:了解海洛因依赖者其它精神障碍的患病情况。方法:应用DSM-Ⅲ-R用定式临床检查手册和DSM-Ⅲ-R人格障碍用定式临床检查手册,调查了113名自愿戒毒的海洛因依赖者DSM-Ⅲ-R轴Ⅰ其它精神障碍和DSM-Ⅲ-R轴Ⅱ人格障碍的诊断情况。结果:心境障碍与物质滥用共患率较高。终生患病率55.7%,现患率60.2%。海洛因依赖者还伴有其它类型的精神活性物质使用障碍,终生患病率是59.2%,现患率是37.2%。轴Ⅱ人格障碍总患病率达到89.7%。边缘型人格障碍(61.7%)和强迫型人格障碍(58.5%)最常见,其次是偏执型人格障碍(52.1%)。结论:自愿戒毒的海洛因依赖者中较多合并其它精神障碍。为了加强治疗效果预防复吸应更加关注共患疾病的诊断和治疗。

Objective： To evaluate the psychiatric comorbidity among heroin dependent patients. Methods： The structured clinical interview for DSM-Ⅲ-R - patient version （SCID-P） and The Structured Clinical Interview for DSM-Ⅲ-R - axis Ⅱ personality disorder （SCID-Ⅱ） were used to assess current and lifetime DSM-Ⅱ-R axis Ⅰ diagnosis and the prevalence of DSM-Ⅲ-R axis Ⅱ personality disorder in 113 heroin dependent patients. Results： The lifetime mood disorders axis Ⅰ diagnosis was 55.7%. The prevalence of personality disorder in axis Ⅱ was 89.7%. Borderline personality disorder （61.7%）, compulsive personality disorder （58.5%） were the most common diagnoses. Conclusion： These findings suggest the clinical importance of obtaining both axis Ⅰ and axis Ⅱ diagnoses in heroin dependent patients and highlight the need for treatment that focuses on diagnosed mental disorders in substance abusers.