住院酒依赖患者合并酒精所致其他精神障碍及独立精神障碍的特征  

Characteristics of comorbidities of alcohol-induced and independent mental disorders in hospitalized patients with alcohol dependence

作　　者：聂鹰[1] 李铃铃 王月华 童永胜[2,3,4] 杨可冰 王雪莲[2,3,4] 吴涧蓝 赵荣江 牛雅娟[1] NIE Ying;LI Ling-ling;WANG Yue-hua;TONG Yong-sheng;YANG Ke-bing;WANG Xue-lian;WU Jian-lan;ZHAO Rong-jiang;NIU Ya-juan(The Second Department,Beijing Huilongguan Hospital,Beijing 100096,China;Peking University Huilongguan Clinical Medical School,Bejing 100096,China;Beijing Suicide Research and Prevention Center,Beijing Huilongguan Hospital,Bejing 100096,China;WHO Collaborating Center for Research and Training in Suicide Prevention,Beijing 100096,China)

机构地区：[1]北京回龙观医院临床二科,北京100096 [2]北京大学回龙观临床医学院,北京100096 [3]北京回龙观医院北京心理危机研究与干预中心,北京100096 [4]WHO心理危机预防研究与培训合作中心,北京100096

出　　处：《中国药物依赖性杂志》2023年第5期430-435,共6页Chinese Journal of Drug Dependence

基　　金：北京市医院管理中心“登峰”计划专项经费(DFL20221701);北京市医院管理中心临床医学发展专项经费资助(ZYLX202130);北京市留学人员科技活动择优资助;首都临床诊疗技术研究及转化应用项目(Z211100002921039)。

摘　　要：目的探讨酒精依赖综合征(酒依赖)住院患者合并精神障碍情况及特点。方法在某专科医院连续纳入住院酒依赖患者,采用DSM-IV诊断工具SCID-I详细评估患者是否有其他精神障碍并鉴别是否由酒精所致。结果完成访谈的287例酒依赖住院患者中,171例(59.6%)患除酒依赖之外的DSM-IV轴I障碍(终身患),其中106例(36.9%)为现患。最常见的是酒精所致精神病性障碍(终身患38.7%、现患22.6%)、独立精神障碍(15.0%、7.3%)、酒精所致的心境障碍(14.3%、9.1%)。酒精所致的精神病性症状中,常见的依次是幻视(59.5%)、幻听(50.5%)和被害妄想(21.6%)。结论住院酒依赖患者合并酒精所致其他精神障碍和独立精神障碍的比例非常高,制定酒依赖治疗方案时须充分考虑各种合并精神障碍的评估和治疗。Objective To investigate the occurrence and characteristics of alcohol-induced and Axis Iindependent mental disorders in inpatients with alcohol dependence.Methods Inpatients with alcohol dependence were consecutively enrolled in a mental health hospital,and detailed interviews were administered by mental health professionals with SCID-I(Structured Clinical Interview for DSM-IV-TR Axis I Disorders).The diagnosis of alcohol dependence,alcohol-induced mental disorders,and other Axis I independent mental disorders were identified via the interview.Clinical characteristics of alcohol dependence and other data were also collected.Results Of the 287 inpatients who completed the interviews and met for diagnostic criteria of alcohol dependence for DSM-IV,171(59.6%)had comorbidities with lifetime DSM-IV Axis I disorder other than alcohol dependence,of which 106(36.9%)met for diagnostic criteria of current(past 1 month)Axis I disorders other than alcohol dependence.The most common comorbidities were alcohol-induced psychotic disorders(lifetime 38.7%,current 22.6%),independent mental disorders(lifetime 15.0%,current 7.3%),and alcoholinduced mood disorders(lifetime 14.3%,current 9.1%).Among the alcohol-induced psychotic symptoms,the most common were visual hallucination(59.5%),auditory hallucinations(50.5%)and delusion of persecution(21.6%).Conclusion The proportion of comorbidities of alcohol-induced and other independent mental disorders is substantially high among inpatients with alcohol dependence.Therefore,the evaluation and treatment for other Axis I mental disorders,especially mood disorders(both of alcohol-induced and independent),should be fully considered in the management of alcohol dependence.

关 键 词：酒精依赖综合征 共病 非物质所致精神障碍 酒精所致其他精神障碍 

分 类 号：R749[医药卫生—神经病学与精神病学]