DIAGNOSIS OF ALCOHOL-USE DISORDERS IN SCHIZOPHRENIA
DIAGNOSIS OF ALCOHOL-USE DISORDERS IN SCHIZOPHRENIA
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DOI：
10.1093/schbul/16.1.57
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发表时间：
1990-01-01
影响因子：
6.6
通讯作者：
BEAUDETT, MS
中科院分区：
文献类型：
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作者：
DRAKE, RE;OSHER, FC;BEAUDETT, MS
酒精使用障碍是精神分裂症的常见共病，其存在与不良适应和不良治疗反应有关。标准的酒精评估工具还没有被验证用于精神分裂症患者，一些作者质疑这些患者自我报告的有效性。需要一个可靠和有效的筛查程序来评估酒精使用情况。本研究采用以下三种方法对75例精神分裂症或情感性精神障碍的农村门诊患者进行评估：（1）临床记录;（2）使用标准酒精评估工具的研究访谈;（3）病例管理者的评级。此外，通过将所有三种方法的信息与密集的病例审查相结合确定的共识诊断用于确定其他方法的灵敏度和特异性。正如预期的那样，临床评估经常遗漏酒精问题。研究访谈和个案管理者的评级区分酒精和非酒精性精神分裂症患者，并高度相关。个案经理的评级，其中包括纵向观察的行为和附带报告以及访谈数据，是更敏感的措施，目前的酒精使用障碍比研究访谈。受试者经常表现出酒精相关的问题，干扰社区调整没有完全依赖综合征，这表明精神分裂症患者可能特别容易受到酒精的负面影响。
Alcohol use disorders are common comorbid conditions in schizophrenia, and their presence is associated with poor adjustment and poor treatment response. Standard alcohol assessment instruments have not been' validated for use with schizophrenic patients, and several authors have questioned the validity of these patients' selfreports. A reliable and valid screening procedure for assessing alcohol use is needed. The present study used the following three methods to evaluate a rural sample of 75 outpatients withDSM-III-Rschizophrenia or schizoaffective disorder: (1) clinical records; (2) research interviews using standard alcohol assessment instruments; and (3) case managers' ratings. In addition, consensus diagnoses, determined by combining information from all three methods with intensive case reviews, were used to determine the sensitivity and specificity of the other approaches. As expected, clinical evaluations frequently missed alcohol problems. Research interviews and case managers' ratings differentiated between alcoholic and nonalcoholic schizophrenic patients and were highly correlated. Case managers' ratings, which incorporated longitudinal observations of behavior and collateral reports as well as interview data, were more sensitive measures of current alcohol use disorders than research interviews. Subjects frequently manifested alcohol-related problems that interfered with community adjustment without the full dependence syndrome, suggesting that schizophrenic patients may be particularly vulnerable to negative effects of alcohol.