精神活性物质所致精神病性障碍转归状况及其影响因素研究

Surveys of outcome of psychotic disorders due to psychoactive substance use and influencing factors

目的：探讨精神活性物质（毒品）所致精神病性障碍转归状况及其影响因素。方法对374例精神活性物质所致精神病性障碍患者进行随访。结果72．5％患者完成了随访，随访期间复吸率达88．9％，随访前6个月内仍有吸毒行为者占17．0％；69．0％患者随访期内接受过住院治疗。患者首次入院后精神病性症状1个月内完全缓解者占62．9％（症状短暂型），6个月内精神病性症状逐渐缓解者占28．2％（症状持久型），＞6个月仍残留部分幻觉、妄想等精神病性症状者占8．9％（症状残留型）；症状残留型组吸毒年限、精神病家族史阳性率、多次住院率、随访时存在精神病性症状率均显著高于症状短暂型组及症状持久型组（P＜0．01），初次吸毒年龄显著小于症状短暂型组及症状持久型组（P＜0．01）；多种物质滥用率显著高于症状短暂型（P＜0．05）。结论多数精神活性物质所致精神病性障碍患者预后较好，但部分患者预后不良，脱离毒品后可能仍然长期残留精神病性症状。

Objective To explore the outcome of psychotic disorders due to psychoactive substance use and influencing factors .Methods A total of 374 patients with psychotic disorders due to psychoactive sub-stance use were followed up .Results 72 .5 percent of patients completed follow-up ,relapse rate was 88 .9% during follow-up ,patients keeping drug taking made up 17 .0% within first 6 months of follow-up ;69 .0% of patients rehospitalized during follow-up .Patients w hose psychotic symptoms completely relieved within 1 month after first admission made up 62 .9% （transient symptom ） ,ones gradually did within 6 months did 28 .2% （persistent symptom ） ,ones w ho remained partial hallucination and delusion after 6 months did 8 .9% （residual symptom ）;drug taking time ,positive rate of psychosis family history ,rehos-pitalization ,diverse substance abuse and residual notable psychotic symptom rate were significantly higher in residual than both transient and persistent symptom group （P〈0 .01） ,age of first drug-taking was low-er （P〈0.01） ,and hospitalization time longer （P〈 0.01） .Conclusion The prognosis of most patients with psychotic disorders due to psychoactive substance use is better ,that of partial ones is poor ,and they may remain psychotic symptoms for a long time after separating oneself from drug .