Long-term follow-up of patients treated for psychotic symptoms that persist after stopping illicit drug use.
Long-term follow-up of patients treated for psychotic symptoms that persist after stopping illicit drug use.
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DOI：
10.3969/j.issn.1002-0829.2012.05.004
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发表时间：
2012-10
期刊：
影响因子：
--
通讯作者：
Yang X
中科院分区：
文献类型：
--
作者：
Deng X;Huang Z;Li X;Li Y;Wang Y;Wu D;Gao B;Yang X
在中国，诊断为药物性精神障碍的患者的长期预后尚不清楚。评估曾入住精神病院治疗因使用非法药物引起的精神症状的患者的病程和精神症状的严重程度。首次入院时有精神病症状且在入院前一个月内使用过违禁药物的患者在入院后13至108个月进行随访。对患者及其家属进行出院后药物使用和精神病症状的访谈。确定的258名患者主要是年轻的无业男性，他们最常见的滥用药物是甲基苯丙胺，并且在入院时平均滥用药物7年。在这些患者中，189例（73%）被定位并重新访谈；168人（89%）重新开始使用非法药物，25人（13%）在随访期间需要再次住院。在114例（60%）患者中，精神病症状在停药后不到1个月内消失，56例（30%）患者症状持续1至6个月，19例（10%）患者症状持续超过6个月（其中8例诊断为精神分裂症）。与其他两组相比，症状持续超过6个月的患者在入院前更有可能有精神疾病家族史，发病年龄更早，药物滥用持续时间更长；他们也更有可能在随访期间再次住院，并在随访期间出现精神病症状。在我们的样本中，大多数物质诱发的精神障碍患者有良好的长期预后，但那些早期开始非法使用药物、长期使用药物或有精神疾病家族史的患者更有可能发展为慢性精神病。需要进一步的前瞻性研究来确定非法药物的神经毒性作用与使用非法药物的人发展为慢性精神病的个体易感特征之间的关系。
The long-term outcome of patients diagnosed with drug-induced psychotic disorders in China is unknown. Assess the course of illness and severity of psychiatric symptoms in patients previously admitted to a psychiatric hospital for treatment of psychotic symptoms that were induced by the use of illicit drugs. Patients with psychotic symptoms at the time of their first psychiatric admission who had used illicit drugs in the month prior to admission were followed up 13 to 108 months after admission. Patients and coresident family members were interviewed about post-discharge drug use and psychotic symptoms. The 258 identified patients were primarily young, unemployed males whose most common drug of abuse was methamphetamines and who had been abusing drugs for an average of 7 years at the time of admission. Among these patients 189 (73%) were located and reinterviewed; 168 (89%) had restarted illicit drug use and 25 (13%) had required rehospitalization over the follow-up period. In 114 patients (60%) the psychotic symptoms resolved in less than 1 month after stopping the drugs, in 56 (30%) the symptoms persisted for 1 to 6 months, and in 19 (10%) the symptoms persisted for longer than 6 months (in 8 of these the diagnosis had changed to schizophrenia). Compared to the other two groups, patients whose symptoms persisted more than 6 months were more likely to have a family history of mental illness, an earlier age of onset and a longer duration of drug abuse prior to the index admission; they were also more likely to have been re-hospitalized during the follow-up period and to have psychotic symptoms at the time of follow-up. Most patients with substance-induced psychotic disorders in our sample had a good long-term prognosis but those who started illegal drug use early, used drugs for prolonged periods, or had a family history of psychiatric illnesses were more likely to develop a chronic psychosis. Further prospective studies are needed to determine the relationship of the neurotoxic effects of illicit drugs and the predisposing characteristics of the individuals in the development of chronic psychosis in persons who use illicit drugs.