社区美沙酮维持治疗受治者焦虑和抑郁发生状况及其影响因素

The prevalence and associated factors with depression and anxiety among the patients attending the community-based methadone maintenance treatment program in China

目的了解社区美沙酮维持治疗受治者抑郁和焦虑的发生状况及其影响因素。方法随机抽取3省9个社区药物维持治疗门诊,对所有符合研究条件的1 301名受治者进行问卷调查,并分别采用抑郁和焦虑自评量表(SDS,SAS)对调查对象的抑郁和焦虑状况进行评分。以不同人口学特征、药物滥用和美沙酮维持治疗情况等作为分组变量,对不同组间的抑郁和焦虑评分进行方差分析,分别以抑郁和焦虑得分为应变量进行多元线性回归分析。结果美沙酮维持治疗受治者中抑郁和焦虑的发生率分别为38.3%(498/1 301)和18.4%(239/1 301)。多因素分析显示,在α=0.05水平时,影响抑郁评分的变量是性别和有无职业;影响焦虑评分的变量是性别、有无职业、文化程度、近期药物滥用(偷吸)和美沙酮维持治疗剂量。多因素与单因素分析结果基本一致。结论社区美沙酮维持治疗受治者中存在一定比例的抑郁和焦虑患者,门诊医务人员应高度关注受治者的心理问题、情感障碍和毒品偷吸间关系,加强对受治者的心理咨询干预和社会心理支持。

Objective To understand the prevalence and the factors associated with depression and anxiety among patients attending the community-based methadone maintenance treatment （MMT） program. Methods 9 MMT clinics in 3 provinces were randomly selected, in which 1 301 MMT patients who met the criteria of recruitment were all interviewed. A cross-sectional study by administrative ques- tionnaire was employed to investigate the demographics, drug abuse and MMT treatment status of the respondents. The 1301 respondents were also evaluated for depression and anxiety by SDS （Self-Rating Depression Scale） and SAS （Self-Rating Anxiety Scale） respectively. ANOVA and multivariate linear regressions analysis was used to verify the factors associated with depression and anxiety respectively. Results The prevalence of depression and anxiety among the MMT patients were 38.3 % （498/1 301） and 18.4% （239/1 301 ）. The multivariates linear regression analysis indicated that at the level of a = 0.05, gender, employment status were associated with depression, while gender, employnrnent status, educational level, drug abuse and methadone daily dosage were associated with anxiety. Conclusions There are certain proportions of MMT clients who suffer from depression and anxiety. The MMT clinic staff should put more emphasis on the efforts to reduce psychological disorders and its potential risks by enhancing psychological councelling, intervention and social support towards the MMT patients.