参与美沙酮维持治疗的海洛因成瘾者自我报告的抑郁症状严重程度:一项横断面调查（英文）  

Cross-sectional study of the severity of self-reported depressive symptoms in heroin users who participate in a methadone maintenance treatment program

作　　者：吴亚飞 闫世艳 鲍艳萍 连智 曲直 刘志民 无 

机构地区：[1]Weinan Vocational and Technical College,Shanxi,China [2]China Academy of Chinese Medical Sciences,Beijing,China [3]National Institute on Drug Dependence,Peking University,Beijing,China

出　　处：《上海精神医学》2016年第1期35-41,共7页Shanghai Archives of Psychiatry

基　　金：supported by the‘Shi’er Wu’project of the Ministry of Science and Technology of the People’s Republic of China(project number:2012BAI01B07)

摘　　要：背景:美沙酮维持治疗(methadone maintenance treatment,MMT)是一种公认的有效降低毒瘾的措施。美沙酮维持治疗可以减少海洛因成瘾戒断症状,并因此可以提供心理和社会支持,对吸毒者的康复至关重要。目标:比较目前正在接受MMT的海洛因成瘾者和没有接受MMT的海洛因成瘾者之间的抑郁症状严重程度。方法:本研究运用了Beck-13(13-item version of the Beck Depression Inventory,BDI-13)抑郁自评量表和人口学历史资料调查表,对中国三个城市9个美沙酮治疗中心的929例正在接受MMT的海洛因成瘾患者(平均已接受9个月MMT治疗)和已经在中心注册参加MMT治疗但尚未开始的238例海洛因成瘾患者进行评估。结果:与正在接受MMT的成瘾者中有68%(628/929)报告抑郁症状相比,79%(188/238)的未治疗成瘾者报告有抑郁症状(X2=11.69,p<0.001)。未经治疗组的BDI评分中位数(四分位区间)是10.4(7.9-11.4),而MMT组BDI评分中位数是8.0(5.7-11.6),两者有显著差异(Z=2.75,p=0.006)。在MMT组内,自我报告的抑郁症状严重程度与参加MMT时间呈负相关(rs=-0.24,Z=2.88,p=0.004)。多元线性回归分析发现,在控制所有人口学变量后,治疗组的抑郁症状严重程度仍然轻于非治疗组。在控制MMT疗效后,自我报告家庭关系较差(β=0.118,t=6.56,p<0.001)以及离异(β=0.120,t=3.73,p<0.001)的海洛因成瘾患者抑郁症状较严重。结论:中度至重度抑郁症状常见于海洛因成瘾患者。MMT治疗与海洛因成瘾患者抑郁症状较轻相关,但需要采用前瞻性随机对照试验来确定MMT是否确实改善了海洛因成瘾患者的抑郁症状。与家庭成员的关系较差也与海洛因成瘾患者的抑郁症状有关,这表明对海洛因成瘾患者的治疗需要纳入一些方法来帮助海洛因成瘾患者修复由于他们成瘾造成的社会关系割裂。Background： Methadone maintenance treatment（MMT） is widely recognized as an effective method of combatting narcotic addiction. MMT reduces heroin withdrawal symptoms and, thus, makes it possible to provide the psychological and social support that is essential to the rehabilitation of drug users.Aim： Compare the severity of depressive symptoms in heroin users who are currently receiving MMT to that of heroin users who are not receiving MMT.Methods： We administered the 13-item version of the Beck Depression Inventory（BDI-13） and a demographic history form to 929 heroin users who had been receiving MMT at nine methadone treatment clinics in three Chinese cities for an average of 9 months and to 238 heroin users who had enrolled in a MMT program at the centers but had not yet begun MMT. Results： Seventy-nine percent（188/238） of the untreated individuals reported depressive symptoms compared to 68%（628/929） of the individuals receiving MMT（X2=11.69, p0.001）. The median（interquartile range） BDI score in the untreated group was 10.4（7.9-11.4） compared to 8.0（5.7-11.6） in the MMT group（Z=2.75, p=0.006）. In the MMT group, there was a negative correlation between the severity of reported depressive symptoms and the duration of participation in the MMT program（rs=-0.24, Z=2.88, p=0.004）. Multivariate linear regression analysis showed that after adjusting for all demographic variables the treated group still had less severe depressive symptoms than the untreated group. After adjusting for the effect of MMT treatment, depressive symptoms were more severe in heroin users who self-reported poor family relationships（standardized regression coefficient [beta]=0.118, t=6.56, p0.001） and in those who were divorced（beta=0.120, t=3.73, p0.001）.Conclusions： Moderate to severe depressive symptoms are common in heroin users. MMT is associated with lower levels of depressive symptoms in heroin users, but prospective randomized controlled trials are needed to determine whether or

关 键 词：美沙酮维持治疗 海洛因滥用 抑郁 中国 

分 类 号：R749.64[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]