Probability and predictors of remission from life-time prescription drug use disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions
Probability and predictors of remission from life-time prescription drug use disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions
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DOI：
10.1016/j.jpsychires.2012.08.019
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发表时间：
2013-01-01
影响因子：
4.8
通讯作者：
Schwartz, Robert P.
中科院分区：
文献类型：
--
作者：
Blanco, Carlos;Secades-Villa, Roberto;Schwartz, Robert P.
虽然处方药使用障碍(PDUD)已经成为一个重要的、日益严重的公共卫生问题，但人们对其过程知之甚少。这项研究的目的是估计镇静剂、镇静剂、阿片类药物和兴奋剂的累积缓解概率，并确定跨物质缓解的预测因素。对终生滥用或依赖镇静剂(n=402)、镇静剂(n=372)、阿片类药物(n=521)和兴奋剂(n=765)的个人进行了分析，这是在全国酒精及相关疾病流行病学调查(NESARC)第一波中进行的。获得了普通人群PDUD缓解的累积概率估计和风险比。对于所有被评估的物质，终身累积缓解概率估计在96%以上。半数PDUD患者在发病后4~5年缓解。对于较年轻的个体，PDUD的缓解程度更大。男性表现出较低的兴奋剂使用障碍缓解风险。人格障碍的诊断降低了镇静剂和兴奋剂缓解的可能性。只有滥用或依赖一些处方药会降低其他PDUD缓解的可能性，而其他药物紊乱并不能预测缓解。相当大比例的PDUD患者在一生中的某个时候会得到缓解。研究发现，缓解的预测因素大多是特定于物质的，而不是跨物质普遍存在的。一些人口亚群的减少率较低，突出表明有必要加强弱势人口亚群的预防和干预努力。(C)爱思唯尔有限公司出版的2012年。
While prescription drug use disorders (PDUD) has become an important and growing public health problem, little is known about their course. This study aims to estimate cumulative probability of remission from sedatives, tranquilizers, opioids and stimulants, and to identify predictors of remission across substances. Analyses were done for the sub-sample of individuals with lifetime history of abuse or dependence on sedatives (n = 402), tranquilizers (n = 372), opioids (n = 521), and stimulants (n = 765) at Wave 1 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Cumulative probability estimates and hazard ratios for remission from PDUD were obtained for the general population. Lifetime cumulative probability estimates of remission were above 96% for all substances assessed. Half of the cases of PDUD remitted between 4 and 5 years after onset. Remission from PDUD was greater for younger individuals. Males exhibited lower hazards of remission for stimulants use disorder. A diagnosis of personality disorders decreased probability of remission for sedatives and stimulants. Only abuse or dependence on some prescription drugs decreased the probability of remission from other PDUD, whereas other drug disorders did not predict remission. A significant proportion of individuals with PDUD achieve remission at some point in their life-time. Predictors of remission were found to be mostly substance-specific rather than common across substances. The lower rates of remission among some subgroups of the population highlight the need to strengthen preventive and intervention efforts among vulnerable population subgroups. (C) 2012 Published by Elsevier Ltd.