The course of anxiety, depression and drinking behaviours after completed detoxification in alcoholics with and without comorbid anxiety and depressive disorders
The course of anxiety, depression and drinking behaviours after completed detoxification in alcoholics with and without comorbid anxiety and depressive disorders
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DOI：
10.1093/alcalc/36.3.249
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发表时间：
2001-05-01
影响因子：
2.8
通讯作者：
Junghanns, K
中科院分区：
文献类型：
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作者：
Driessen, M;Meier, S;Junghanns, K
我们研究了共病的焦虑和抑郁障碍治疗酗酒者，目前的焦虑和抑郁症的过程中的早期和晚期戒毒期间，出院后的饮酒行为之间的关联。使用复合国际诊断访谈（CIDI）对100名酗酒者进行了终生精神共病评估。研究分为三个亚组：DA组（共病抑郁和焦虑障碍，n = 15），A组（仅焦虑障碍，n = 23）和NO组（无共病障碍，n = 62）。从停止饮酒后21 ± 13天开始，每周（t1至t4）评估一次状态焦虑（STAT-XI）、特质焦虑（STAI-X2）和抑郁（BDI），并在出院后6个月（t5，n = 68）再评估一次。戒毒后的前4周内，所有亚组的精神病理学严重程度均降低。然而，从t1到t4，特质焦虑在两个共病亚组中保持在较高水平。在随访样本中，60.5%的非共病受试者保持禁欲，但只有26.7%的共病患者和12.5%的共病抑郁症伴严重的当前特质焦虑或抑郁症患者在t1。独立于他们的合并症状态，复发者在t5已经报告了更多的特质焦虑比戒酒者在t1。我们的结论是，严重的特质焦虑持续3周的禁欲后，共病抑郁和/或焦虑障碍，这些与中度或重度当前的焦虑和抑郁状态的组合代表复发的风险最大，因此可能表明需要治疗。
We studied the associations between comorbid anxiety and depressive disorders in treated alcoholics, the course of current anxiety and depression during the early and late post-detoxification periods, and drinking behaviours after discharge. Lifetime psychiatric comorbidity was assessed in 100 alcoholics using the Composite International Diagnostic Interview (CIDI). Three subgroups defined as group DA (comorbid depressive and anxiety disorders, n = 15), group A (anxiety disorder only, n = 23), and group NO (no comorbid disorder, n = 62) were studied. Beginning 21 +/- 13 days after cessation of drinking, state anxiety (STAT-XI), trait anxiety (STAI-X2) and depression (BDI) were assessed once per week (t1 to t4) and once more 6 months after discharge (t5, n = 68). The severity of psychopathology decreased during the first 4 weeks after detoxification in all subgroups. However, trait anxiety remained at higher levels in both the comorbid subgroups from t1 to t4. In the follow-up sample, 60.5% of the non-comorbid subjects remained abstinent, but only 26.7% of all comorbid patients and only 12.5% of those with comorbid depressive disorder plus severe current trait anxiety or depression at t1. Independent of their comorbidity status, relapsers at t5 had already reported more trait anxiety than abstainers at t1. We conclude that severe trait anxiety persisting after 3 weeks of abstinence, comorbid depressive and/or anxiety disorders, and combinations of these with moderate or severe current anxiety and depressive states represent the greatest risks of relapse and therefore may indicate a treatment need.