Clinical Epidemiology of Single Versus Multiple Substance Use Disorders Polysubstance Use Disorder
Clinical Epidemiology of Single Versus Multiple Substance Use Disorders Polysubstance Use Disorder
复制标题
DOI：
10.1097/mlr.0000000000000731
复制
发表时间：
2017-09-01
期刊：
影响因子：
3
通讯作者：
Rosenheck, Robert A.
中科院分区：
文献类型：
--
作者：
Bhalla, Ish P.;Stefanovics, Elina A.;Rosenheck, Robert A.
目的：虽然对药物滥用的研究主要集中在患有单一药物使用障碍（SUD）的人身上，但许多人滥用多种药物。研究尚未检查诊断为1种以上SUD的患者的独特特征，以及多物质使用障碍（PSUD）患者与单一SUD患者的差异。方法：国家退伍军人健康管理局2012财年的数据用于比较被诊断为1 SUD的退伍军人与被诊断为2-3和>3 SUD的退伍军人的人口统计学特征、精神病和医学诊断，医疗和精神病服务利用率，以及精神病药物填充。结果：在472，624名至少有1种SUD的退伍军人中，346，329人（73.2%）有1种疾病，113，598人（24.0%）有2-3种疾病，12，715人（2.7%）有>3种SUD。PSUD水平较高的退伍军人更有可能是黑人和无家可归者，更有可能患有肝病以及精神分裂症，双相情感障碍，重度抑郁症和人格障碍。较高水平的PSUD与更多的使用精神科住院治疗，住宅和康复治疗，并与多个精神药物处方fills.Conclusions：退伍军人与PSUD有更严重的问题沿着几个方面，并使用更多的和不同的服务比那些1 SUD。这种独特的临床特征保证了研究开发和评估治疗复杂多病性疾病患者的方法，这些疾病涉及医学发病率和心理社会功能障碍之间的相互作用。
Objective: While research on substance abuse has largely focused on people who have a single substance use disorder (SUD), many people abuse multiple substances. Studies have yet to examine the distinctive characteristics of patients diagnosed with more than 1 SUD and how those with polysubstance use disorder (PSUD) differ from those with a single SUD.Methods: National Veterans Health Administration data from fiscal year 2012 were used to compare veterans diagnosed 1 SUD to veterans diagnosed with 2-3, and >3 SUDs on demographic characteristics, psychiatric and medical diagnoses, medical and psychiatric service utilization, and psychotropic medication fills. Comparisons of the 3 groups were based on bivariate and multiple logistic regression analyses.Results: Of the 472,624 veterans with at least 1 diagnosed SUD, 346,329 (73.2%) had 1 disorder, 113,598 (24.0%) had 2-3, and 12,715 (2.7%) had >3 SUDs. Veterans with higher levels of PSUD were more likely to be black and homeless, were more likely to have hepatic disease as well as schizophrenia, bipolar disorder, major depressive disorder, and personality disorders. Higher levels of PSUD were associated with greater use of psychiatric inpatient care, residential and rehabilitative treatment, and with multiple psychotropic medication prescription fills.Conclusions: Veterans with PSUD have more severe problems along several dimensions and use more numerous and varied services than those with 1 SUD. This distinctive clinical profile warrants research to develop and evaluate methods for treating patients with complex multimorbid disorders that involve interactions between medical morbidity and psychosocial dysfunction.