海洛因依赖者《美国精神障碍诊断与统计手册（第四版）》轴I障碍的终身患病情况分析  

Axis I comorbidity of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders among heroin-dependent patients

作　　者：杨梅[1] 廖艳辉[1] 王强[2] 王红[3] VasishKavi 刘铁桥[1] 郝伟[1] 

机构地区：[1]中南大学湘雅二医院精神卫生研究所,长沙410011 [2]四川大学华西医院精神科 [3]湖南省脑科医院

出　　处：《中华精神科杂志》2013年第1期8-12,共5页Chinese Journal of Psychiatry

基　　金：国家“十二五”科技支撑项目（2012BA101B00）;国家自然科学基金（81130020）;国家“973”课题（2009CB522000）

摘　　要：目的调查我国海洛因依赖者中《美国精神障碍诊断与统计手册（第4版）》（DSM—IV）轴I精神障碍和其他物质使用障碍的终身患病情况。方法对湖南省3家戒毒机构的1002例海洛因依赖者进行横截面调查；采用自制调查表收集一般资料；采用《DSM—IV-TR轴I障碍定式临床检查患者版》（SCID—I／P）调查DSM．IV轴I障碍的终身患病情况。结果1002例海洛因依赖者中，共病心境障碍191例，终身患病率为19．1％，主要诊断是重性抑郁障碍135例，占13．5％；共病焦虑障碍128例，终身患病率为12．8％，主要诊断是创伤后应激障碍81例，占8．1％；有579例（57．8％）患有其他物质使用障碍，其中以镇静催眠抗焦虑药使用障碍和酒精使用障碍最常见，分别为303例（30．3％）和275例（27．5％），兴奋剂使用障碍和致幻剂使用障碍也较常见，分别为148例（14．8％）和127例（12．7％）。结论我国海洛因依赖者的共病和其他物质使用障碍的情况非常普遍，应得到高度的关注和相应的诊治。Objective To provide lifetime rates of axis I comorbidities of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders （DSM-IV） among patients with heroin dependence. Methods A cross-section study was conducted. Subjects were 1002 heroin-dependent patients who were consecutively admitted into three drug rehabilitation settings in Hunan province. A questionnaire was developed to get demographic and drug use-related information of the subjects. Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition （SCID-I/P ） was used for making lifetime DSM-IV axis I diagnoses. Results Among the subjects, mood disorder was the most common type of co- occurring axis I non-substance use mental disorders （191,19. 1% ）, followed by anxiety disorder （128, 12. 8% ）. Major depression （135,13.5%） was the most common diagnosis among co-occurring mood disorders, whereas post-traumatic stress disorder （PTSD, 81,8. 1% ） was the most common diagnosis among anxiety disorders. 579 （57.8%） subjects had other substance （non-opioid, other than tobacco） use disorders. The most frequent diagnoses of other substance use disorders were sedative-hypnotics use disorder and alcohol use disorder, with lifetime rates of 30. 3% （303） and 27.5% （275） respectively, followed by stimulant and hallucinogen use disorder, with a lifetime rate of 14. 8% （148） for stimulant use disorder and a lifetime rate of 12. 7% （ 127 ） for hallucinogen use disorder. Conclusions Co-occurring non-substance use mental disorders and other substance use disorders among heroin-dependent patients in China are highly prevalent, to which great importance should be attached in the process of diagnosis and treatment.

关 键 词：海洛因依赖 物质相关性障碍 共病 终身患病率 

分 类 号：R74[医药卫生—神经病学与精神病学]