甲基苯丙胺成瘾患者戒断后精神症状的临床变化特征

Characteristics of clinical changes of psychotic symptoms among methamphetamine addicts after withdrawal

目的:了解中重度甲基苯丙胺成瘾患者戒断后相关精神症状临床特征。方法:纳入甲基苯丙胺中、重度成瘾且健康状况较好患者,依据末次使用甲基苯丙胺的时间,分为停用甲基苯丙胺48小时内(急性期)和3-6个月(康复期)两组,采用阳性和阴性症状量表(PANSS)、抑郁评定量表(HAMD)、焦虑评定量表(HAMA)、匹兹堡睡眠质量指数量表(PSQI)和渴求量表,评价甲基苯丙胺成瘾患者的精神病性症状、抑郁、焦虑、睡眠障碍和渴求随戒断时间的变化特征。结果:(1)急性期组和康复期组患者在甲基苯丙胺使用情况方面,差异无统计学意义。(2)无论急性期组还是康复期组,患者均有不同程度的精神病性症状、抑郁、焦虑、睡眠障碍和渴求的临床表现。(3)与急性期组相比,康复期组患者在阳性和阴性症状量表(PANSS)中的阳性因子和一般精神病理因子评分,抑郁量表评分,匹兹堡睡眠质量指数量表(PSQI)中的睡眠质量、入睡时间、睡眠时间和睡眠障碍成分评分,渴求的评分均有一定改善,差异有统计学意义。结论:甲基苯丙胺成瘾患者戒断后出现精神症状,康复期均有一定改善,其中部分指标在急性期与康复期不同阶段区分度较明显。

Objective:To study clinical characteristics of psychotic symptoms in the patients with methamphetamine(MA) moderate-to-severe addiction after withdrawal. Methods:According to the time from the last use of methamphetamine, the patients were divided into first 48 hours group(acute withdrawal period) and 3-6 months group(rehabilitation period), they were moderate-to-severe addictive patients and with good health. The psychopathic syndrome, depression, anxiety, sleep disorder and craving were evaluated with Positive and Negative Syndrome Scale( PANSS), Hamilton Depression Scale(HAMD), Hamilton Anxiety Scale(HAMA), Pittsburgh sleep quality index(PSQI) and craving VAS. Results:(1) There was no significant difference in the use of methamphetamine between the acute withdrawal group and the rehabilitation group.(2) No matter in the acute withdrawal group or in the rehabilitation group, the patients have different degrees of psychotic symptoms, depression, anxiety, sleep disorders and craving clinical manifestations.(3) There were improved and statistically significant in the PANSS score(positive factor, general psychopathology factor), depression scale score, PSQI score(sleep quality, sleeping time, sleep time, sleep disorder) and craving score, between the rehabilitation group and the acute stage group. Conclusion:In rehabilitation period, the psychotic symptoms of methamphetamine withdrawal were improved and some of the indexes were clearly differentiated between the acute stage and the rehabilitation stage.