海洛因依赖者共患心境障碍的相关因素  

Related factors of co-occurring mood disorders among heroin-dependent patients

作　　者：杨梅[1] 廖艳辉[1] 王强[2] 王红[3] Vasish Kavi 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6期350-355,共6页Chinese Journal of Psychiatry

基　　金：国家自然科学基金重点项目（81130020）;“十二五”支撑计划（2012BAI01B00）

摘　　要：目的 探讨影响海洛因依赖者共患心境障碍的相关因素.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《美国精神障碍诊断与统计手册（第4版）》（DSM-Ⅳ）-TR轴Ⅰ障碍定式临床检查病人版（SCID-I/P）调查DSM-Ⅳ轴Ⅰ障碍的终身患病情况.根据是否终身患有心境障碍,将调查对象分为共患心境障碍组（191例）和不共患心境障碍组（811例）.采用单因素与多因素logistic回归方法分析影响共患心境障碍的相关因素.结果 单因素分析显示,离异或丧偶[OR=1.65,95％可信区问（CI） 1.06 ～2.59]、童年负性经历（OR=1.58,95％ CI 1.11 ～2.25）、首次使用海洛因动机为缓解苦闷或烦恼（OR =2.41,95％ CI1.48～3.92）、首次使用海洛因体验为难受（OR=1.61,95％ CI1.16～2.24）、强制戒毒次数（3～5次,OR=2.33,95％ CI 1.02 ～5.28;≥6次,OR=3.17,95％ CI1.27～7.88）、患有慢性躯体疾病（OR=1.90,95％ CI 1.36～2.66）、DSM-Ⅳ轴Ⅰ精神障碍阳性家族史（OR=2.03,95％ CI1.17～3.55）、患有其他物质使用障碍（OR=2.19,95％ CI 1.55 ～ 3.09）、焦虑障碍（OR=2.48,95％ CI1.65 ～3.73）和躯体形式障碍（OR=2.10,95％ CI1.17 ～3.77）与海洛因依赖者共患心境障碍相关;多因素分析显示,首次使用海洛因动机为缓解苦闷或烦恼（OR=2.48,95％ CI1.47 ～ 4.20）、首次使用海洛因体验为难受（OR=1.61,95％ CI1.15 ～2.26）、患有慢性躯体疾病（OR=1.92,95％ CI 1.34～2.74）、其他物质使用障碍（OR =2.19,95％ CI1.55 ～3.09）、焦虑障碍（OR=2.48,95％ CI1.65～3.73）和躯体形式障碍（OR =4.48,95％ CI2.04～9.84）最终进入回归模型.结论 负性情绪、躯体疾病、其他物质使用障碍和精神障碍可能是影响海洛因依赖者共患心境障碍的相关因素.Objective To explore related factors of co-occurring mood disorders among heroin-dependent patients.Methods A cross-sectional study was conducted.Subjects were 1002 heroin-dependent patients who were consecutively admitted into three drug rehabilitation institutes in Hunan Province.A questionnaire was developed to get demographic and drug use-related information of the subjects.The Structured Clinical Interview for DSM-Ⅳ-TR Axis Ⅰ Disorders-Patient Edition （SCID-I/P） was used for the lifetime DSM-Ⅳ axis Ⅰ diagnoses.According to the co-occurrence of mood disorders,the heroin-dependent subjects were assigned into two groups：one group contained individuals with mood disorders in their lifetimes （n =191）,and the other contained individuals without mood disorders （n =881）.Bivariate and multivariate logistic regression were used to detect related factors of co-occurring mood disorders among the heroindependent patients.Results By bivariate analyses,the factors related to co-occurring mood disorders were being divorced or widowed （OR =1.65,95％ CI 1.06-2.59）,childhood adversity （OR =1.58,95％ CI 1.11-2.25）,to alleviate depression or be worry at the first time of using heroin（OR =2.41,95％ CI 1.48-3.92）,feeling uncomfortable from the first time of heroin use（OR =1.61,95％ CI 1.16-2.24）,times of receiving compulsive rehabilitation （3-5 times,OR =2.33,95％ CI 1.02-5.28; ≥ 6 times,OR =3.17,95％ CI 1.27-7.88）,having chronic physical diseases （OR =1.90,95％ CI 1.36-2.66）,family history of DSM-Ⅳ axis Ⅰ mental disorders （OR =2.03,95％ CI 1.17-3.55）,having lifetime diagnoses of other substance use disorders （OR =2.19,95％ CI 1.55-3.09）,anxiety disorders （OR=2.48,95％ CI 1.65-3.73）,and somatoform disorders（OR =2.10,95％ CI 1.17-3.77）.By multivariate analyses,the factors finally entered into the logistic regression models were to alleviate depression or worry at the first time use of heroin （OR =2.48,95 ％ CI 1.47-4.20）,feeling uncomfortable from t

关 键 词：海洛因依赖 情绪障碍 共病 相关因素 

分 类 号：R749.61[医药卫生—神经病学与精神病学]