二醋吗啡依赖患者康复期治疗中的心理分析及对策探讨  

Countermeasure discussion and psychological analysis of the patients with heroin dependence during the stage of rehabilitation

作　　者：李祯英[1] 张丽娟[1] 王勇[1] 钟兵[1] 方勇飞[1] 李成明[1] 

机构地区：[1]解放军第三军医大学西南医院药物依赖治疗所,重庆市400038

出　　处：《中国临床康复》2003年第18期2570-2571,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的了解二醋吗啡依赖者生理脱毒后在康复治疗中的心理状态,寻求有效的预防复吸措施。方法采用焦虑自评表(SAS)、抑郁自评量表(SDS)、药物滥用复吸原因调查表对50例二醋吗啡依赖者生理脱毒后口服纳曲酮、曲唑酮行康复治疗中的心理状态进行为期6个月的问卷调查。结果50例被调查者中,1～5个月内有38例脱失而复吸(76%),未复吸6个月以上12例(24%)。SAS:20项总分标准分47.1±16.1、正15项单分2.3±0.7和负5项单分3.8±0.7均高于常模(t=24.4,16.5,25.9;P均<0.01)。SDS总分54.0±3.2,高于常模41.9±8.6(t=4.303,P<0.01)。焦虑、抑郁、心里空虚、精神依赖、好奇、攀比是主要的自身心理状态;毒友、毒贩的引诱,吸毒环境的诱惑,无业、失意,家庭及社会冷漠、歧视等社会因素构成了主要的负性心理压力。结论脱毒后行康复治疗中必须给予患者坚持不懈的心理疏导、行为矫治,持之以恒的家庭、社会关爱、支持,国家各政府部门严格监控、管制,综合治理社会环境,清除毒源,才能使吸毒者真正从生理-心理-社会上达到完全康复而回归社会。Aim To evaluate the mental status of patients with heroin dependence during the stage of rehabilitation after physiological detoxification and find o ut an effective method for preventing relapse.Methods The mental status of 50 pati ents with heroin dependence, who were treated with naltrexone and trazodone duri ng the stage of rehabilitation after physiological detoxification, was investiga ted by using Self-rating Anxiety Scales(SAS),Self-rating Depression Scales(SDS ) and Drug Abuse and Relapse Factors Questionnaire for 6 months.Results There we re 38 relapses (76%) and 12 non-relapses (24%) within 6 months. The average s core of SAS was 47.1±16.6, including the 15-item positive score(2.3±0.7) and the 5-item negative score(3.8±0.7),significantly higher than those of the norm al(t=24.4,16.5,25.9,P< 0.01). The total score of SDS was 54.0±3.2, also signifi cantly higher than that of the normal(t=4.303,P< 0.01).The main self-psychologi cal stress consisted of anxiety, depression, vacuity, mental dependence,curiosit y and peacockery.The main negative psychological stress consisted of enticement from drug fellow and trafficker, lure of drug abuse surrounding, unemployment,ap athy of family and discrimination of society.Conclusion Some measures such as lo ng-term psychological treatment, behavior correction, support from family and s ociety, management of government, control of social environment and limination o f drug source must be applied to the patients with heroin dependence during the stage of rehabilitation after detoxification, which make them recovery and come back to society on the aspect of physiology-psychology-society indeed.

关 键 词：二醋吗啡依赖 心理分析 康复治疗 预防 复吸 焦虑自评表 抑郁自评量表 药物滥用 

分 类 号：R595.5[医药卫生—内科学] R493[医药卫生—临床医学]