THE USE OF ALCOHOL AND DRUGS TO SELF-MEDICATE SYMPTOMS OF POSTTRAUMATIC STRESS DISORDER
THE USE OF ALCOHOL AND DRUGS TO SELF-MEDICATE SYMPTOMS OF POSTTRAUMATIC STRESS DISORDER
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DOI：
10.1002/da.20677
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发表时间：
2010-08-01
影响因子：
7.4
通讯作者：
Bolton, James M.
中科院分区：
文献类型：
--
作者：
Leeies, Murdoch;Pagura, Jina;Bolton, James M.
背景资料：自我药疗被认为是创伤后应激障碍（PTSD）和物质使用障碍之间高并发症发生率的一种解释;然而，PTSD自我药疗的知识很少。我们描述了一般人群中PTSD自我药疗的患病率和相关性。研究方法：数据来自全国酒精和相关疾病流行病学调查第2波（N = 34，653;应答率：70.2%），这是一项具有全国代表性的社区成年人精神疾病调查。对酒精和药物的自我药疗进行了单独评估。患病率确定自我药物治疗的个人与DSM-IV PTSD。回归分析确定了自我药疗与各种相关因素之间的关联，包括社会人口因素、共病精神障碍、自杀企图和生活质量。结果：大约20%的PTSD患者使用物质试图缓解症状。男性比女性更有可能进行自我药疗行为。在调整后的模型中，使用非法药物或滥用处方药来控制PTSD症状与心境恶劣和边缘性人格障碍的可能性大幅增加有关。在控制精神障碍合并症后，自我药疗与自杀企图的高几率（调整后的比值比= 2.46; 95%置信区间1.53-3.97）和精神健康相关的生活质量较低独立相关。结论：自我药疗是社区中PTSD患者的常见行为，但具有潜在的危险后果。卫生保健从业人员应评估PTSD患者使用药物的原因，以确定精神病发病率较高的亚组。抑郁和焦虑27：731-736，2010. (C)2010 Wiley-Liss，Inc.
Background: Self-medication has been proposed as an explanation for the high rates of comorbidity between posttraumatic stress disorder (PTSD) and substance use disorders; however, knowledge of self-medication in PTSD is scarce. We describe the prevalence and correlates of self-medication in PTSD in the general population. Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (N = 34,653; response rate: 70.2%), a nationally representative survey of mental illness in community-dwelling adults. Self-medication was assessed separately for alcohol and drugs. Prevalence rates were determined for self-medication among individuals with DSM-IV PTSD. Regression analyses determined associations between self-medication and a variety of correlates, including sociodemographic factors, comorbid mental disorders, suicide attempts, and quality of life. Results: Approximately 20% of individuals with PTSD used substances in an attempt to relieve their symptoms. Men were significantly more likely than women to engage in self-medication behavior. In adjusted models, using illicit drugs or misusing prescription medications to control PTSD symptoms was associated with a substantially higher likelihood of dysthymia and borderline personality disorder. After controlling for mental disorder comorbidity, self-medication was independently associated with higher odds of suicide attempts (adjusted odds ratio = 2.46; 95% confidence interval 1.53-3.97) and lower mental health-related quality of life. Conclusions: Self-medication is a common behavior among people with PTSD in the community, yet has potentially hazardous consequences. Health care practitioners should assess reasons for substance use among people with PTSD to identify a subgroup with higher psychiatric morbidity. Depression and Anxiety 27:731-736, 2010. (C) 2010 Wiley-Liss, Inc.