Gender differences in clinical outcomes for cocaine dependence: Randomized clinical trials of behavioral therapy and disulfiram
Gender differences in clinical outcomes for cocaine dependence: Randomized clinical trials of behavioral therapy and disulfiram
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DOI：
10.1016/j.drugalcdep.2014.10.007
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发表时间：
2014-12-01
影响因子：
4.2
通讯作者：
Carroll, Kathleen M.
中科院分区：
文献类型：
--
作者：
DeVito, Elise E.;Babuscio, Theresa A.;Carroll, Kathleen M.
背景：尽管对成瘾的性别差异进行了广泛的研究，但在随机临床试验中评估的基于证据的治疗方法中，比较女性和男性治疗结果的发表报告相对较少。方法：从5个可卡因依赖治疗的随机临床试验（N = 434）中收集数据，对临床结果的性别差异进行评估。二级分析比较了药物治疗条件（双硫仑与无药物治疗）和多种行为治疗条件下结果的性别差异。结果：与男性相比，女性在治疗期间和治疗后随访中对可卡因使用的多种测量结果较差。这些结果似乎主要是由于双硫仑对女性的疗效不如男性。没有证据表明在行为治疗评估的结果中存在有意义的性别差异。结论：这些发现表明，女性和男性可能从一些经验验证的成瘾行为治疗中受益程度相似。相反，一些成瘾药物治疗，如双硫仑，可能与女性相对于男性的较差结果有关，这表明在广泛临床应用之前，有必要对两性的药物治疗进行仔细评估。2014爱思唯尔爱尔兰有限公司版权所有。
Background: Despite extensive research on gender differences in addiction, there are relatively few published reports comparing treatment outcomes for women versus men based on evidence-based treatments evaluated in randomized clinical trials.Methods: An aggregate sample comprised of data from five randomized clinical trials of treatment for cocaine dependence (N = 434) was evaluated for gender differences in clinical outcomes. Secondary analyses compared gender differences in outcome by medication condition (disulfiram versus no medication) and across multiple behavioral treatment conditions.Results: Women, compared with men, had poorer treatment outcomes on multiple measures of cocaine use during treatment and at post-treatment follow-up. These results appear to be primarily accounted for by disulfiram being less effective in women compared with men. There was no evidence of meaningful gender differences in outcome as a function of the behavioral therapies evaluated.Conclusions: These findings suggest that women and men may benefit to similar degrees from some empirically validated behavioral treatments for addiction. Conversely, some addiction pharmacotherapies, such as disulfiram, may be associated with poorer outcomes among women relative to men and point to the need for careful assessment of pharmacological treatments in both sexes prior to widespread clinical implementation. (C) 2014 Elsevier Ireland Ltd. All rights reserved.