真实环境中酒依赖患者戒断后心理渴求的潜伏现象

INCUBATION OF CRAVING DURING ABSTINENCE IN PATIENTS WITH ALCOHOL DEPENDENCE IN REAL WORLD

目的:研究真实环境中酒依赖患者戒断后心理渴求随时间的变化规律,为临床上酒依赖维持治疗时间和预防复发提供理论依据。方法:收集符合DSM-Ⅳ酒依赖诊断标准且操守1个月以上的76例酒依赖患者,采用视觉模拟标尺(Visual Analog Scale,VAS)评估戒酒后1年内不同时间点的心理渴求程度,并采用自编调查表调查戒酒后心理渴求增加时的原因、症状表现、应对方式。结果:重复测量方差分析发现,跟戒断第1天相比,酒依赖患者在戒断第3天、7天、14天、1个月、3个月、6个月、12个月时VAS评分先增加后下降,在第3个月时达最高,在第12个月时降至与第1天相当水平,总体呈倒U字型,其中第1个月、3个月、6个月时VAS评分升高有统计学意义(P分别为0.004、0.001、0.002)。酒依赖患者戒断后心理渴求增加的常见原因为自身心理渴求及负性情绪,常见症状表现为心烦,常见应对方式为强忍不喝。结论:真实环境中酒依赖患者戒断后存在心理渴求的潜伏现象。

Objectjve： To investigate the time - dependent changes of alcohol craving during abstinence in patients with alcohol dependence in real world, and to provide a theoretical basis for the course of maintenance treatment and relapse prevention. Methods ： We collected 76 alcoholics who were in accordance with the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4t1＇ edition, （ DSM - IV） alcohol dependence and withdrawal from alcohol at least 1 month. The Visual Analog Scale （VAS） was used to assess the degree of alcohol craving at different time points during 1 year abstinence. The causes of wanting to drink, symptoms and coping styles when craving increased during abstinence were collected by self - compiled questionnaire. Results ： Compared with the first withdrawal day by repeated measures ANOVA, VAS score of patients with alcohol dependence withdrawal for 3 days, 7 days, 14 days, I month, 3 months, 6 months and 12 months initially increased gradually, and reached the highest in the third month, then decreased gradually, and then returned to initial level of the first day in year,just like ＂inverted U＂. The VAS score at the points of 1 month, 3 months, and 6 months was statistically significant compared with the first day （P = 0. 004, 0. 001, 0. 002, respectively）. Most common causes of increased craving in patients with alcohol dependence after withdrawal were craving and negative mood, most common symptoms were anxiety, most common coping way was not drinking with will. Conclusion：Alcohol craving showed the incubation during abstinence in patients with alcohol dependence in real world.