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among a convenient sample of 598 male drug users who received detoxification treatment from the 5th Compulsory Detention and
Forced Detoxification Center of Yunnan Province and Dali Compulsory Detention and Forced Detoxification Center between August
and November,2020. According to the diagnosis of SUD,the participants were divided into three groups:opioid use disorder
group(n=245),methamphetamine use disorder group(n=197)and double use disorder group(n=146). The Chinese
version of SCID- Ⅰ /P was used to assess the prevalence of common axis Ⅰ mental disorders(psychosis disorder,affective
disorder,alcohol use disorder,and sedative-hypnotic use disorder). The lifetime prevalence of these disorders among the three
groups was compared. Results Among the 598 cases,there were 588 cases diagnosed with SUD(opioid,methamphetamine,
or both). The lifetime prevalence of psychosis disorder,alcohol use disorder, sedative and hypnotic use disorder among the
three groups was significantly different(P < 0.05). The overall lifetime prevalence of schizophrenia,other primary and drug
induced psychotic disorders was 15.82%. The lifetime prevalence of psychotic disorder in opioid use disorder group(5.31%)was
lower than that of methamphetamine use disorder group(20.30%)or that of double use disorder group(27.40%)(P<0.05).
The overall lifetime prevalence of affective disorders was 21.77%. To be specific,the lifetime prevalence of affective disorders was
17.14% in opioid use disorder group,25.38% in methamphetamine use disorder group,and 24.66% in double use disorder group.
The overall lifetime prevalence of alcohol use disorder was 42.18%. Specifically,opioid use disorder group had lower lifetime
prevalence of alcohol use disorder than methamphetamine use disorder group(35.10% vs 45.69%) and than double use disorder
group(35.10% vs 49.32%)(P<0.05). The overall lifetime prevalence of sedative or hypnotic use disorder was 13.61%. The
lifetime prevalence of sedative or hypnotic use disorder was 19.18%,22.60% and 0 in opioid use disorder group,double use
disorder group,and methamphetamine use disorder group,respectively. Conclusion The prevalence of the above-mentioned
mental disorders in drug users in Yunnan Province was much higher than that in the general population. Moreover,these mental
disorders may be even more prevalent in methamphetamine use disorder population than in opioid use disorder population.
【Key words】 Substance-related disorders;Opioid-related disorders;Methamphetamine;Schizophrenia;Psychotic
disorders;Drug users;Yunnan;Cross-sectional studies
物质使用障碍(substance use disorder,SUD)是指 1 对象与方法
使用一种或多种精神活性物质导致的精神或行为障碍。 1.1 调查对象 本研究为横断面调查研究,采用方便
SUD 作为一种慢性复发性脑病在临床及科研上受到越来 抽样法选取 2020 年 8—11 月在云南省第五强制隔离戒
越多的关注 [1-2] 。与普通人群相比,SUD 患者更容易罹 毒所和大理州强制隔离戒毒所进行戒毒治疗的男性戒毒
患其他精神疾病,如精神病性障碍 [3] 、情感障碍 [4] 、 学员 598 例为调查对象。纳入标准:(1)男性;(2)
人格障碍 [5] 、创伤后应激障碍 [6] 等。国外对 SUD 共 年龄≥ 18 岁;(3)调查时意识清晰、愿意参与本次调研。
患疾病的流行病学调查较多 [7] ,国内对这一问题的研 排除标准:(1)严重精神或躯体疾病,无法完成问卷;(2)
究主要集中在上海 [8] 、长沙 [9] 等地。尽管人们观察到 不会讲汉语,只会少数民族语言,无法交流。本研究已
SUD 与其他精神疾病的共患现象,但不同成瘾性 SUD 通过云南省药物依赖防治研究所伦理委员会审批(云药
人群、不同国家和地区的调查结果具有较大差异。云南 依伦审 202004 号),调查对象均对本研究知情同意并
省作为我国非法成瘾性物质即毒品流行的重灾区,目前 签署知情同意书。
在吸毒人群中 SUD 与精神疾病共患情况的相关研究仍 1.2 调查工具及内容 本研究采用自制问卷收集调查
是一片空白。根据我国 2021 年毒情形势报告 [10] ,目 对象的基本资料,包括一般人口学特征(年龄、民族、
前我国使用人数最多的两类毒品为阿片类物质和甲基苯 婚姻状况、受教育程度、入所前 1 年职业状况、入所
丙胺类兴奋剂(amphetamine-type stimulants,ATS), 前 1 年收入、入所前 1 年居住情况、吸烟情况)、病
前者具有镇静、镇痛、抑制呼吸、抑制胃肠蠕动等作 毒感染情况〔丙型肝炎病毒(hepatitis C virus,HCV)
用 [11] ,后者则为中枢神经兴奋剂 [11] ,因此吸毒人群 感 染、 人 类 免 疫 缺 陷 病 毒(human immunodeficiency
中 SUD 以阿片类 SUD 与 ATS 类 SUD 为主。为此,本 virus,HIV)感染〕和毒品使用情况等。采用 DSM- Ⅳ -
研究以强制隔离戒毒机构内的戒毒学员为调查对象,开 TR 轴Ⅰ障碍临床定式检查病人版(Structured Clinical
展阿片类 SUD 与 ATS 类 SUD 戒毒学员中常见轴Ⅰ精神 Interview for DSM- Ⅳ -TR AXIS Ⅰ Disorders,research
疾病的筛查,旨在了解云南省吸毒人群 SUD 与常见轴 version for patients,SCID- Ⅰ /P) [12] 中文版,对常见
Ⅰ精神疾病的共患情况,为吸毒人群的戒毒治疗提供 轴Ⅰ精神疾病(精神病性障碍、情感障碍、酒精 SUD、
参考。 镇静催眠药 SUD)进行诊断,并比较不同 SUD 戒毒学