The effect of comorbid substance use disorders on treatment outcome for anxiety disorders
The effect of comorbid substance use disorders on treatment outcome for anxiety disorders
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DOI：
10.1016/j.janxdis.2007.11.007
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发表时间：
2008-08-01
影响因子：
10.3
通讯作者：
Shand, Fiona
中科院分区：
文献类型：
--
作者：
McEvoy, Peter M.;Shand, Fiona
本研究探讨了并发物质使用障碍（SUD）对针对焦虑症的心理治疗结果的影响。研究1（N = 484）旨在确定社区焦虑症诊所样本中SUD的患病率，以及共病SUD对完成认知行为治疗（CBT）的子样本（n = 200）结局的影响。大约四分之一（22-29%）患有一种或两种焦虑症的患者符合至少一种SUD的标准，但患有三种焦虑症的患者的这一比例要高得多（46%）。与没有SUD的患者相比，并发SUD与更高水平的焦虑相关，但与抑郁或压力无关。然而，并发SUD并不影响治疗结局。研究2（N = 103）的重点是酒精使用对诊断特异性症状的措施和一般措施的痛苦和残疾的影响，CBT课程后恐慌症或社交恐惧症。治疗前饮酒并不能预测惊恐症状、表现焦虑、痛苦或残疾的变化，但它确实能预测社交焦虑的变化。问题饮酒本身在治疗结果方面没有任何预测效用。这些研究结果表明，临床医生治疗原发性焦虑症和并发SUD患者可以相对乐观的治疗结果。(c)2007爱思唯尔有限公司版权所有。
This study examined the impact of concurrent substance use disorders (SUDs) on outcomes for psychotherapy targeting anxiety disorders. Study 1 (N = 484) sought to determine the prevalence of SUDs in a sample referred to a community anxiety disorders clinic, as well as the impact of comorbid SUDs on outcomes for a subsample (n = 200) completing cognitive behavior therapy (CBT). Around one-quarter (22-29%) of patients with one or two anxiety disorders met criteria for at least one SUD, but this rate was substantially higher (46%) for patients with three anxiety disorders. Concurrent SUDs were associated with higher levels of anxiety but not depression or stress, compared to those without a SUD. However, concurrent SUDs did not moderate treatment outcomes. Study 2 (N = 103) focused on the impact of alcohol use on diagnosis-specific symptom measures and generic measures of distress and disability, following a course of CBT for panic disorder or social phobia. Pre-treatment alcohol use did not predict changes in panic symptoms, performance anxiety, distress, or disability, but it did predict changes in social interaction anxiety. Problem drinking per se did not have any predictive utility in terms of treatment outcome. These findings suggest that clinicians treating patients for a primary anxiety disorder and concurrent SUD can be relatively optimistic about treatment outcomes. (c) 2007 Elsevier Ltd. All rights reserved.