Posttraumatic stress disorder and short-term outcome in early methadone treatment
Posttraumatic stress disorder and short-term outcome in early methadone treatment
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DOI：
10.1016/s0740-5472(99)00088-4
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发表时间：
2000-07-01
影响因子：
3.9
通讯作者：
Fraser, D
中科院分区：
文献类型：
--
作者：
Hien, DA;Nunes, E;Fraser, D
本研究的目的是确定治疗依从性相对于暴力和创伤后应激障碍（PTSD）的新美沙酮患者的频率。对90例阿片类药物滥用患者进行了儿童期身体和性虐待（CPSA）、成年期暴力暴露（ADVIOL）、PTSD和治疗依从性评估。总体而言，43%的受试者在接受治疗后3个月内退出治疗。创伤或PTSD的发生并不能预测辍学率。然而，以入院时使用其他药物的严重程度作为协变量的2（性别）× 2（PTSD）协方差分析（ANCOVA）显示PTSD的主效应，F（4，71）= 7.69，p小于或等于0.01，因此，目前患有PTSD的患者在3个月时显示出显著更多的持续药物使用（M = 24.3，SD = 20.9）显著高于（M = 8.9，SD = 11.8）。使用2（性别）× 2（PTSD）ANCOVA对持续使用可卡因的检查也显示PTSD的主效应，F（4，17）= 8.24，p小于或等于0.005，因此，目前患有PTSD的患者在入院后3个月时显示出显著更多的持续使用可卡因（M = 51.6，SD = 37.6），而无（M = 24.3，SD = 20.9）。对于两种性别，CPSA和ADVIOL与较高的PTSD发生率相关，这反过来又预测了较差的治疗依从性，这是通过入院后3个月持续同时发生的药物滥用来衡量的。结果强调需要常规评估和有针对性的治疗美沙酮患者的创伤。(C)2000 Elsevier Science Inc. All rights reserved.
The aim of this study was to determine treatment adherence relative to frequency of violence and posttraumatic stress disorders (PTSD) among new methadone patients. Ninety-sis opiate-abusing patients were evaluated for childhood physical and sexual abuse (CPSA), adulthood exposures to violence (ADVIOL), PTSD, and treatment adherence. Overall, 43% of the subjects dropped out of treatment within 3 months of intake. Occurrence of trauma or PTSD did not predict drop-out rates. A 2 (Gender) x 2 (PTSD) analysis of covariance (ANCOVA) with severity of other drug use on admission as a covariate, however, revealed a main effect for PTSD, F(4, 71) = 7.69, p less than or equal to .01, such that those patients with current PTSD revealed significantly more ongoing drug use at 3 months (M = 24.3, SD = 20.9) than those without (M = 8.9, SD = 11.8). Examination of ongoing cocaine use using a 2 (Gender) x 2 (PTSD) ANCOVA also revealed a main effect for PTSD, F(4, 17) = 8.24, p less than or equal to .005, such that those patients with current PTSD revealed significantly more ongoing cocaine use at 3 months postadmission (M = 51.6, SD = 37.6) than those without (M = 24.3, SD = 20.9). For both genders, CPSA and ADVIOL were associated with higher rates of PTSD, which in turn predicted poorer treatment adherence as measured by ongoing co-occurring drug abuse 3 months postadmission. Results underscore the need for routine assessment and targeted treatment of trauma in methadone patients. (C) 2000 Elsevier Science Inc. All rights reserved.