COMORBID POSTTRAUMATIC STRESS DISORDER AND OPIATE ADDICTION: A LITERATURE REVIEW
COMORBID POSTTRAUMATIC STRESS DISORDER AND OPIATE ADDICTION: A LITERATURE REVIEW
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DOI：
10.1080/10550887.2013.795467
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发表时间：
2013-04-01
影响因子：
2.3
通讯作者：
Drexler, Karen
中科院分区：
文献类型：
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作者：
Fareed, Ayman;Eilender, Pamela;Drexler, Karen
创伤后应激障碍（PTSD）和阿片类药物依赖共病的治疗一直是许多临床医生面临的挑战。对于这种合并症的治疗，循证指南有限。PTSD和阿片类药物依赖的症状可能会趋同，有时很难区分这两种情况。例如，阿片类药物戒断症状可能与PTSD患者的过度警觉和加剧的惊吓反应相似。一个共同的神经生物学电路建议的病理生理机制，这种并发症。有证据表明，阿片类药物替代疗法可以改善患有PTSD和阿片类药物依赖的阿片类药物成瘾患者的治疗结果。建议对这一人群进行循证心理治疗干预，以改善心理结局。将阿片类药物替代疗法与为患有PTSD和药物滥用共病的个体设计的循证认知行为疗法相结合（例如，寻求安全性）可能会改善该人群的治疗结果。需要更多的研究来了解这种合并症的潜在机制，并改善治疗反应。
Treatment of comorbid posttraumatic stress disorder (PTSD) and opioid dependence has been a challenge for many clinicians. There are limited evidence-based guidelines for treatment of this comorbidity. Symptoms of PTSD and opiate dependence may converge, and it is sometimes difficult to differentiate between both conditions. For example, opioid withdrawal symptoms may mimic the hypervigilance and exacerbated startle response of patients with PTSD. A common neurobiologic circuit is suggested for the pathophysiologic mechanism of this comorbidity. There is evidence that opioid substitution therapy may improve treatment outcomes for opioid addiction in patients with comorbid PTSD and opioid dependence. Evidence-based psychotherapeutic intervention is recommended for this population to improve the psychological outcome as well. Combining opioid substitution therapy with evidence-based cognitive behavioral therapy designed for individuals with comorbid PTSD and substance abuse (e.g., Seeking Safety) may improve treatment outcomes in this population. More research is needed to understand the underlying mechanisms for this comorbidity and to improve treatment response.