云南省吸毒人群物质使用障碍与常见轴Ⅰ精神疾病共患调查研究  

Co-prevalence of Substance Use Disorders and Common AxisⅠDisorders in Yunnan’s Drug Users

作　　者：张官柏[1] 郑玲[1] 杨丽萍[1] 周勤[1] 王飞 和亮泽 程璇 茶丽 李昕悦[1] ZHANG Guanbai;ZHENG Ling;YANG Liping;ZHOU Qin;WANG Fei;HE Liangze;CHENG Xuan;CHA Li;LI Xinyue(Project Development Department,Yunnan Institute for Drug Abuse,Kunming 650228,China;The 5th Compulsory Detention and Forced Detoxification Center of Yunnan Province,Kunming 650211,China;Dali Compulsory Detention and Forced Detoxification Center,Dali 671099,China)

机构地区：[1]云南省药物依赖防治研究所项目发展部,云南省昆明市650228 [2]云南省第五强制隔离戒毒所,云南省昆明市650211 [3]大理州强制隔离戒毒所,云南省大理市671099

出　　处：《中国全科医学》2022年第36期4554-4560,共7页Chinese General Practice

摘　　要：背景目前,吸毒人群中精神疾病共患现象受到越来越多的关注,而云南省作为我国毒品流行重灾区,其吸毒人群中物质使用障碍(SUD)与其他精神疾病共患流调数据仍是空白。目的了解云南省吸毒人群SUD与常见轴Ⅰ精神疾病的共患情况。方法本研究为横断面调查研究,采用方便抽样法选取2020年8—11月在云南省第五强制隔离戒毒所和大理州强制隔离戒毒所进行戒毒治疗的男性戒毒学员598例为调查对象。根据戒毒学员对阿片类和甲基苯丙胺类兴奋剂(ATS)类毒品的SUD情况,将戒毒学员分为三组:阿片类SUD组(245例)、ATS类SUD组(197例)和双重SUD组(146例)。采用DSM-Ⅳ-TR轴Ⅰ障碍临床定式检查病人版(SCID-Ⅰ/P)中文版,对常见轴Ⅰ精神疾病(精神病性障碍、情感障碍、酒精SUD、镇静催眠药SUD)进行诊断,并比较不同毒品SUD戒毒学员中常见轴Ⅰ精神疾病的终生患病率。结果云南省598例男性戒毒学员中存在阿片类SUD、ATS类SUD和双重SUD的戒毒学员共588例。三组戒毒学员精神病性障碍、酒精SUD、镇静催眠药SUD终生患病率比较,差异有统计学意义(P<0.05)。三组戒毒学员中,精神分裂症及其他原发性和物质所致精神病性障碍的终生患病率为15.82%,其中阿片类SUD组戒毒学员精神病性障碍的终生患病率(5.31%)低于ATS类SUD组(20.30%)及双重SUD组(27.40%)(P<0.05);情感障碍的终生患病率为21.77%,阿片类SUD组、ATS类SUD组及双重SUD组戒毒学员中的终生患病率分别为17.14%、25.38%和24.66%;酒精SUD的终生患病率为42.18%,阿片类SUD组戒毒学员酒精SUD的终生患病率(35.10%)低于ATS类SUD组(45.69%)及双重SUD组(49.32%)(P<0.05);镇静催眠药SUD的终生患病率为13.61%,阿片类SUD组、双重SUD组戒毒学员中的终生患病率分别为19.18%和22.60%,ATS类SUD组戒毒学员中无检出。结论常见轴Ⅰ精神疾病在云南省SUD戒毒学员中的终生患病率均高于普通人群同�Background Mental disorders in drug users have received increasing attention.However,there are no any epidemiologic data available in regard to substance use disorders(SUD)and other mental disorders in drug users in Yunnan,one region that is hit hardest by epidemic of drug use in China.Objective To investigate the co-prevalence of SUD and a common mental disorder,axisⅠdisorders,among Yunnan’s drug users.Methods A cross-sectional survey was conducted among a convenient sample of 598 male drug users who received detoxification treatment from the 5th Compulsory Detention and Forced Detoxification Center of Yunnan Province and Dali Compulsory Detention and Forced Detoxification Center between August and November,2020.According to the diagnosis of SUD,the participants were divided into three groups:opioid use disorder group(n=245),methamphetamine use disorder group(n=197)and double use disorder group(n=146).The Chinese version of SCID-Ⅰ/P was used to assess the prevalence of common axisⅠmental disorders(psychosis disorder,affective disorder,alcohol use disorder,and sedative-hypnotic use disorder).The lifetime prevalence of these disorders among the three groups was compared.Results Among the 598 cases,there were 588 cases diagnosed with SUD(opioid,methamphetamine,or both).The lifetime prevalence of psychosis disorder,alcohol use disorder,sedative and hypnotic use disorder among the three groups was significantly different(P<0.05).The overall lifetime prevalence of schizophrenia,other primary and drug induced psychotic disorders was 15.82%.The lifetime prevalence of psychotic disorder in opioid use disorder group(5.31%)was lower than that of methamphetamine use disorder group(20.30%)or that of double use disorder group(27.40%)(P<0.05).The overall lifetime prevalence of affective disorders was 21.77%.To be specific,the lifetime prevalence of affective disorders was 17.14%in opioid use disorder group,25.38%in methamphetamine use disorder group,and 24.66%in double use disorder group.The overall lifetime prevalence

关 键 词：物质相关性障碍 阿片相关性障碍 甲基苯丙胺 精神分裂症 精神病性障碍 吸毒者 云南 横断面研究 

分 类 号：R749[医药卫生—神经病学与精神病学]