The spectrum of substance abuse in bipolar disorder: reasons for use, sensation seeking and substance sensitivity
The spectrum of substance abuse in bipolar disorder: reasons for use, sensation seeking and substance sensitivity
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DOI：
10.1111/j.1399-5618.2007.00383.x
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发表时间：
2007-05-01
影响因子：
5.4
通讯作者：
Cassano, Giovanni Battista
中科院分区：
文献类型：
--
作者：
Bizzarri, Jacopo V.;Sbrana, Alfredo;Cassano, Giovanni Battista
目的：与物质使用障碍患者和健康对照者相比，研究双相I型患者酒精和物质滥用的频谱，包括使用原因，特别关注物质使用、物质敏感性、其他共病精神症状和与感觉寻求相关的特征之间的关系。方法：本研究纳入104例双相I型障碍（BPD I）患者，其中57例（54.8%）符合DSM-IV终身酒精或物质使用障碍（BPD + SUD）标准，35例有物质使用障碍（SUD）且无精神障碍患者和50例健康对照。评估包括DSM-IV轴I障碍的结构化临床访谈（SCID）和物质使用谱的结构化临床访谈（SCI-SUBS）。结果：BPD + SUD和SUD患者在自我用药、物质敏感性和感觉寻求的SCI-SUBS域得分均显著高于BPD患者和健康对照组。药物使用的原因在BPD + SUD患者和SUD患者之间没有差异。最常被引用的是：改善情绪；缓解紧张;减轻无聊;实现/保持兴奋;增加能量。结论：在BPD + SUD和SUD患者中，求助于物质与情绪和焦虑症状、物质敏感性和感觉寻求增加有关。所有BPD患者的物质敏感性和感觉寻求特征应作为与SUD发展相关的可能因素进行调查，以警告患者与不当使用药物和物质相关的特定风险。
Objectives: To examine the spectrum of alcohol and substance abuse, including reasons for use, in patients with bipolar I disorder, compared with patients with substance use disorder and healthy controls, with a specific focus on the relationship between substance use, substance sensitivity, other comorbid psychiatric symptoms and traits related to sensation seeking.Methods: This study included 104 patients with bipolar I disorder (BPD I), of whom 57 (54.8%) met DSM-IV criteria for lifetime alcohol or substance use disorder (BPD + SUD), 35 patients with substance use disorder (SUD) and no psychiatric disorder and 50 healthy controls. Assessments included the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS).Results: Patients with BPD + SUD and SUD had significantly higher scores on the SCI-SUBS domains of self-medication, substance sensitivity and sensation seeking compared with patients with BPD and healthy controls. Reasons for substance use did not differ between patients with BPD + SUD and patients with SUD. Those most frequently cited were: improving mood; relieving tension; alleviating boredom; achieving/maintaining euphoria; and increasing energy.Conclusions: Recourse to substances is associated with increased mood and anxiety symptoms, substance sensitivity, and sensation seeking among patients with BPD + SUD and SUD. Substance sensitivity and sensation seeking traits should be investigated in all patients with BPD as possible factors associated with a development of SUD, in order to warn patients of the specific risks related to improper use of medications and substances.