综合干预对美沙酮维持治疗患者心理状况的影响

The effect of comprehensive intervention on psychologic status in the patients with methadone maintenance therapy

目的:探讨综合干预对美沙酮维持治疗门诊患者心理状况的影响。方法:对41例单纯美沙酮治疗患者、35例美沙酮加心理治疗患者在入组初和治疗1年后分别进行SCL-90测定,并与健康对照组相比。结果:入组初,单纯美沙酮组和美沙酮加心理治疗组的SCL-90各因子分均明显高于对照组(P<0.01);1年后单纯美沙酮治疗组的各因子分仍明显高于对照组(P<0.05,P<0.01),其中强迫、人际敏感、焦虑、恐怖、精神病性和阳性症状数显著低于入组初(P<0.05);1年后美沙酮加心理治疗组的躯体化、强迫、人际敏感、抑郁、恐怖、偏执、精神病性和阳性症状数的分值均高于对照组(P<0.05,P<0.01),所有因子分较入组初相比均明显降低(P<0.05,P<0.01),其中偏执分较单用美沙酮组明显下降(P<0.05)。结论:海洛因依赖患者的心理健康水平低下,美沙酮维持治疗联合心理治疗的综合干预能更好地改善其心理状况。

Objective： To explore the effect of comprehensive intervention on psychologic status of the patients with methadone maintenance therapy （MMT）. Methods： 41 patients accepted MMT and 35 patients accepted MMT with psychological treatment were evaluated with SCL-90 in the beginning of therapy and 1year after thera- py, and compared with healthy controls. Results： The scores of all items of SCL-90 of the two groups were signif- icantly higher than controls in the beginning （P 〈 0.01）. After 1 year of therapy, the scores of obsessive-compul- sive, interpersonal sensiti vity, anxi ety, hosti li ty, phobi c anxiety and positive symptom of the group of MMT were reduced significantly than the beginning （P〈0.05）. All the item scores were still significantly higher compared with controls （P〈0.05, P〈0.01）. After 1 year, the scores of the group of MMT with psychological treatment were significantly higher compared with controls in somatization, obsessive-compulsive, interpersonal sensitivity, de- pression, phobic anxiety, paranoid ideation, psychoticism and positive symptom（P〈0.05, P〈0.01）. And the scores of all the items were reduced significantly than the beginning （P〈0.05, P〈0.01）. The score of paranoid ideation of the patients of MMT with psychological treatment was signi fi cantly lower than the patients of MMT （P 〈 0.05）. Conclusion： The mental healthy status of heroi n addicts are poor. MMT with psychological treatment can improve it more better.