冲动、渴求对男性酒依赖患者复饮的影响  

The effects of impulsivity and craving on relapse in male patients with alcohol dependence

作　　者：蔡海鹏[1] 杜若南 李伟[1] 王志仁[1] 赵荣江[1] 杨清艳[1] 王鑫 杨可冰[1] CAI Hai-peng;DU Ruo-nan;LI Wei;WANG Zhi-ren;ZHAO Rong-jiang;YANG Qing-yan;WANG Xin;YANG Ke-bing(Bejing Huilongguan Hospital/Peking University HuilongGuan Clinical Medical School,Beijing 100096,China)

机构地区：[1]北京回龙观医院/北京大学回龙观临床医学院,北京100096

出　　处：《中国药物依赖性杂志》2023年第2期155-159,164,共6页Chinese Journal of Drug Dependence

基　　金：北京市医院管理局临床医学发展专项(XMLX201834);北京市属医院科研培育计划项目(PX2021072);首都卫生发展科研专项项目(首发2020-2-2134);首都临床诊疗技术研究及转化应用(Z211100002921039)。

摘　　要：目的比较冲动和渴求在男性酒依赖患者与健康对照之间的差异,并探究冲动和渴求对酒依赖患者复饮的影响。方法选取2018年1月至2020年12月在北京回龙观医院的男性酒依赖患者及社区健康男性为研究对象。所有患者均给予常规急性脱瘾治疗,并在治疗后的12周末随访患者的复饮情况。比较酒依赖患者与健康对照在基线人口学资料、冲动方面的差异,并比较复饮组和非复饮组在冲动、渴求方面的差异。结果酒依赖组与健康对照组在年龄、共同居住者、在职情况及受教育年限的比较,差异无统计学意义(P>0.05);但酒依赖患者的吸烟比例、酗酒家族史阳性者比例、酒精使用障碍筛查量表总分(Alcohol Use Disorder Identification Test,AUDIT)、Barratt冲动量表(Barratt Impulsiveness Scale-11,BIS-11)各个分量表分数均高于对照组(P均<0.05)。复饮组患者的Barratt冲动量表的各分量表分数、饮酒迫促性问卷(Alcohol Urgent Questionnaire,AUQ)总分及视觉模拟渴求量表(Visual Analog Scale,VAS)总分均高于非复饮组患者,且差异具有统计学意义(P<0.001)。Logistic回归分析显示,注意冲动性及非计划冲动性是酒依赖患者复饮的危险因素(P均<0.05),较晚的起病年龄和在职状态是酒依赖患者复饮的保护因素(P均<0.05)。结论与健康对照相比,酒依赖患者具有更高的冲动性;复饮者的冲动和渴求均高于未复饮者。注意冲动性及非计划冲动性是酒依赖患者复饮的危险因素,较晚的起病年龄和在职状态是酒依赖患者复饮的保护因素。Objective To compare the differences in impulsivity and craving between male alcohol-dependent patients and healthy controls,and explore the effects of impulsivity and craving on relapse of drinking in patients with alcohol dependence.Methods Male alcohol-dependent patients in Beijing Huilongguan Hospital and healthy men in the community from January 2018 to December 2020 were selected for the study.All patients were given conventional acute detoxification treatment,and patients were followed up at the end of the 12 week post-treatment period for relapse to drinking.Differences in baseline demographic data,impulsivity between alcohol-dependent patients and healthy controls were compared,and differences in impulsivity and craving between the relapsing and non-relapsing groups were compared.Results A total of 114 alcohol-dependent patients and 112 healthy controls,all male,were included in this study.There were no statistically significant differences between the two groups in terms of age,co-residents,employment status and years of education(P>0.05),but the alcohol-dependent patients had more smokers,more positive family history of alcoholism,and higher total alcohol use disorder identification test scores and higher scores on each BIS-1l subscale(all P<0.05).Scores of each BIS-1l subscale,AUQ and VAS were all higher in the patients in the relapsed drinking group than in the non-relapsed drinking group,and the differences were statistically significant(P<0.001).Logistic regression showed that attentional impulsivity and nonplaning impulsivity were risk factors for relapse to alcohol dependent patients(all P<0.05),late onset age and work situation was a protective factor(all P<0.05)for relapse of alcohol dependent patients.Conclusion Compared with non-dependent healthy controls,alcohol-dependent patients have higher impulsivity for alcohol;and patients with relapse behaviors have higher impulsivity and craving than those without relapse behaviors.Attentional impulsivity and nonplaning impulsivity were risk factors

关 键 词：酒依赖 冲动 渴求 复饮 危险因素 

分 类 号：R749[医药卫生—神经病学与精神病学]