The epidemiology of dual diagnosis
The epidemiology of dual diagnosis
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DOI：
10.1016/j.biopsych.2004.06.034
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发表时间：
2004-11-15
影响因子：
10.6
通讯作者：
Kessler, RC
中科院分区：
文献类型：
--
作者：
Kessler, RC
本文回顾了有关双重诊断流行病学的英文文献。文献表明，精神障碍与酒精和药物使用障碍密切相关。最强烈的关联涉及外部化精神障碍和酒精-药物依赖。精神障碍与酒精药物的使用、吸毒者的问题、问题吸毒者的依赖以及终生依赖的人的坚持性有关。这些双重诊断与精神和酒精-药物障碍的严重性和持久性有关。更广泛的精神障碍与尼古丁依赖有关，大多数双重诊断的人报告他们的第一次精神障碍发生在比他们的第一次物质障碍更早的年龄。前瞻性研究证实了这一时间顺序，尽管显著的预测性关联是相互的。对活动期和缓解期精神障碍的比较分析表明，一些原发精神障碍是继发性物质障碍的标志，另一些是继发性物质障碍的致病危险因素。文章最后讨论了流行病学研究可以用来帮助确定目标和评估干预措施的方法，这些干预措施旨在通过治疗早发性原发性精神障碍来预防继发性物质使用障碍。
The English language literature on the epidemiology of dual diagnosis is reviewed. The literature shows mental disorders to be significantly related to alcohol and drug use disorders. The strongest associations involve externalizing mental disorders and alcohol-drug dependence. Mental disorders are associated with alcohol-drug use, problems among users, dependence among problem users, and persistence among people with lifetime dependence. These dual diagnoses are associated with severity and persistence of both mental and alcohol-drug disorders. A wider range of mental disorders is associated with nicotine dependence, Most people with dual diagnosis report their first mental disorder occurred at an earlier age than their first substance disorder. Prospective studies confirm this temporal order, although significant predictive associations are reciprocal. Analyses comparing active and remitted mental disorders suggest that some primary mental disorders are markers and others are causal risk factors for secondary substance disorders. The article closes with a discussion of ways epidemiologic research can be used to help target and evaluate interventions aimed at preventing secondary substance use disorders by treating early-onset primary mental disorders.