慢性酒中毒患者心理缺陷感及外控性的临床调查分析

目的：了解慢性酒中毒患者的心理缺陷感及外控性。方法：采用缺陷感量表（FIS）与成人Nowich Strick land内－外控制量表（ANSIE）对30例慢性酒中毒患者及30例健康成人进行测评。结果：慢性酒中毒患 者的心理民评分明显低于健康成人,即在社交、学习能力、外貌、体能及总分呈生 差异;同时外控性评分显著高于健康成人。结论：慢性酒中毒患者的强烈心理缺陷及外控性不利于彻底戒酒。     

SCL－90对海洛因依赖者的测试分析

ＳＣＬ－９０对海洛因依赖者的测试分析广东省阳江市复退军人医院（５２９５００）黄雄，黄柳青，杨东荣症状自评量表（ＳＣＬ－９０）近年来在精神医学领域得到了广泛的应用，为了解海洛因依赖者这类特殊人群的心理状况，本文应用ＳＣＬ－９０对我院住院的６０例海洛因依...     

立体定向手术治疗海洛因依赖的远期随访分析

目的评估立体定向毁损术治疗海洛因依赖的手术疗效,分析术后复吸原因。方法回顾性分析接受脑立体定向术的154例海洛因成瘾者的临床资料,采用症状自评量表对病人精神卫生状况进行调查随访。结果随访154例,时间5~6年,其中复吸52例(33.8%,复吸组),未复吸102例(66.2%,未复吸组)。复吸组术后躯体化、强迫症状、敌对、偏执、精神病性等因子明显高于未复吸组和国内常模(均P<0.05)。结论立体定向手术是海洛因依赖的安全有效的治疗方法。强迫症状和人格障碍的改善是消除心理依赖的基础及手术戒毒治疗成功的重要因素;精神病性和躯体化是复吸的主要原因。     

立体定向毁损术治疗海洛因心理依赖(18个月随访分析)

目的探讨立体定向毁损治疗海洛因心理依赖手术疗效及安全性。方法应用立体定向手术治疗海洛因心理依赖58例,并于术后3个月、18个月进行随访,采用上门家访或电话随访。随访内容包括复吸与否、生活工作情况、有无神经精神功能障碍。上门家访时进行了渴求量表、欲望量表、记忆、智商、人格等精神心理测验。结果未复吸36例,复吸16例,失访6例,操守率为62.06%。记忆、智商、性欲比术前提高,无人格、行为等精神障碍。结论立体定向手术治疗海洛因心理依赖疗效明显优于常规药物戒毒治疗,是消除吸毒者心理依赖、摆脱毒瘾的有效方法,且对智力、欲望、思维、人格无明显负面影响。     

男女海洛因依赖者成瘾严重程度的比较

目的：了解男女海洛因依赖者成瘾严重程度的差异,为针对不同性别海洛因依赖者制定干预措施提供依据。方法：采用自制个案调查表和成瘾行为严重度指数量表（addiction severity index,ASI）对199例男性和239例女性海洛因依赖者进行评估,比较不同性别海洛因依赖者ASI量表中各维度分值的差异。结果：女性依赖者ASI中因子4（药物使用）评分平均为（0.52±0.28）分和因子7（精神健康状况）平均（0.15±0.24）分显著高于男性的（0.43±0.34）分和（0.08±0.19）分（P〈0.05或P〈0.01）;男性依赖者因子5（法律状况）评分平均（0.07±0.13）分高于女性的（0.03±0.10）分（P〈0.01）。将年龄、首次吸毒年龄及吸毒时间与ASI分量表进行偏相关分析发现,年龄（r=-0.182）、吸毒时间（r=0.158）与因子4（药物使用）分数存在显著相关;进一步相关分析发现,年龄与吸毒时间存在显著相关（r=0.364,P〈0.01）。结论：男女海洛因依赖者在成瘾行为严重程度方面存在差异,临床治疗与康复过程中应针对不同性别特征制定个体化的治疗方案以满足不同性别患者的需求。     

44例海洛因依赖者复吸的临床分析

４４例海洛因依赖者复吸的临床分析潘柳萍，邓振芬本文试图通过对海洛因依赖者戒毒后复吸的临床资料进行分析，探讨如何减少戒毒后复吸的综合措施．资料与方法资料来源：分析对象为１９９３年１０月～１９９４年４月到我院戒毒并确诊为海洛因依赖者，首次戒毒的病例除外。...     

443例海洛因依赖者戒毒后复吸的心理社会因素分析

４４３例海洛因依赖者戒毒后复吸的心理社会因素分析郑洪波，方少心，冯容妹对４４３例在我院接受戒毒治疗后回归社会的海洛因依赖者进行调查，现报告如下：资料与方法对象均系１９９０年５月以来在我院接受戒毒治疗且居住在本市区的海洛因依赖者，本资料随访日期为１９９...     

对海洛因依赖者心理健康与应对方式的研究

目的了解海洛因依赖者的心理健康状况及应对方式。方法对入组的60例吸毒者,在脱毒后、出所前、出所随访中作SCL-90和简易应对方式的测查,并与正常对照组比较分析。结果SCL-90和简易应对方式各因子均值比较,心理症状戒毒组比正常对照组高（P〈0.05）,积极应对戒毒组比正常对照组低（P〈0.05）,消极应对戒毒组比正常对照组高（P〈0.05）,消极应对与心理症状显著相关（P〈0.05）。出所前组与正常男性比较,仅其他因子（睡眠饮食障碍）戒毒者高（P〈0.05）。所外随访未复吸组与正常对照男性比较,无显著差异（P〉0.05）。回顾未复吸组在往所戒毒期间与正常对照男性比较,有躯体化、强迫、抑郁、焦虑、敌对、精神、其他7个因子和总均分有显著差异（P〈0.05）,17例复吸者作了同样的比较分析,除积极应对因子外,余因子均有显著差异（P〈0.05）。17例复吸者再入所时,各因子均值高于正常对照组（P〈0.05）。结论吸食海洛因成瘾可造成吸毒者心理健康状况恶化和应对方式不良,心理症状与消极应对方式相关,有诸多心理健康问题和对社会应激事件通常采用消极应对方式的戒毒者,其复吸的可能性要大。     

海洛因依赖者环境线索诱发心理生理反应

目的：了解海洛因依赖者对吸毒相关环境线索诱发反应。方法：对来自自愿戒毒机构的36例刚完成生理脱毒（康复早期）的海洛因依赖者和劳教戒毒机构112例康复期满1年的海洛因依赖者观看吸毒相关视频同时给予海洛因模拟物及吸毒用具刺激,于暴露前后自评渴求程度、情绪以及戒断症状反应;用生物反馈仪自动记录暴露前后的生理反应。结果：环境线索暴露后海洛因依赖者心理渴求、害怕／焦虑、抑郁／悲伤、戒断症状、心率、皮肤导电和肌电增高（P〈0．05）,中性／放松／自然降低（P〈0．05）。自愿戒毒机构康复早期海洛因依赖者环境诱发心率增高,比康复期满一年以上者更明显（P〈0．05）,其余与康复期长短无显著关系。结论：海洛因依赖者戒断康复期的延长并不会使渴求和环境诱发心理生理反应减弱或消褪。     

海洛因依赖者自愿戒毒前后焦虑抑郁的评定

目的：探讨海洛因依赖者治疗前后焦虑抑郁症状。方法：对78例海洛因依赖者以抑郁自评问卷(BDI-l3)和汉密尔顿焦虑量表(HAMA)于治疗前后各评定1次。结果：治疗前有焦虑症状者52例，有抑郁症状者45例；治疗后分别为29和28例，均有明显减少。BDI-l3及HAMA评分亦明显下降。结论：经脱毒治疗，焦虑抑郁症状减少，有利于患者心理康复，但仍需加强心理护理。     

Alexithymia and Self-Esteem in a Sample of Opioid Dependent Males: a Controlled Study

The aim of this study was to evaluate the prevalence of alexithymia in opioid dependents compared to the controls and to examine the relationship between alexithymia and depression, anxiety, and self-esteem in opioid dependents. Fifty male heroin-dependent outpatients who completed the detoxification process according to DSM-IV TR diagnostic criteria and 50 control subjects matched for age, gender, and education status who do not abuse heroin or any other substances were included in the study. Subjects were interviewed by using the Structured Clinical Interview for DSM-IV (SCID-I). Variables of interest were assessed according to Toronto Alexithymia Scale-20 (TAS-20), Rosenberg Self-Esteem Scale (RSES), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Forty-two percent of the opioid dependents were estimated as alexithymic according to the cut-off scores of TAS-20 (> 61), while this ratio was 10% for the control group. The mean TAS-20 score in the dependent group was significantly higher than in the control group. BDI, BAI, and RSES scores were also found to be significantly higher in the dependent group, particularly in the alexithymic opioid dependent group. There were significant positive correlations between TAS-20 and BDI, BAI, and RSES scores. Further studies are needed to understand the negative effects of alexithymia and lower self-esteem on opioid dependence.

     

Recidivism among male subjects incarcerated for illicit drug use in Taiwan

Illicit drug users are generally considered both patients and criminals in Taiwan. This study presents drug use behaviors and criminal recidivism of male subjects incarcerated for illicit drug use in Taiwan after detoxification at a detention center. This study also examined the relationship between drug use behaviors and subsequent recidivism. Charts and crime records of 794 male patients from the acute detoxification unit in a detention center in northern Taiwan were reviewed. These subjects were incarcerated for methamphetamine or/and heroin use. The authors examined the relationship between the variables collected during detoxification and subsequent recidivism of illicit drug use in the following 5 years after detoxification. Of 794 subjects, 539 (67.9%) were repeat offenders during the following 5 years after detoxification. Their recidivism occurred primarily within the first 2 years after being released into the community. The recidivism rate for heroin users was significantly higher than that of methamphetamine users. Aged under 30 years, a previous criminal record, and a positive urine analyses test for illicit drugs upon entering the detoxification unit were significantly associated with recidivism. Recidivism rates of illicit drug users in Taiwan after detoxification in the detention center were substantially high. The efficacy of detoxification programs at detention centers in Taiwan needs to be re-evaluated.     

Fear of intimacy among dating couples

Fear of intimacy among heterosexual dating couples was examined with the Fear-of-Intimacy Scale (FIS) and the Personal Assessment of Intimacy in Relationships (PAIR). Following a 6-month interval, couples were again contacted to determine whether they continued to date. Males reported higher FIS scores than females, and FIS scores were positively correlated within couples. Also, FIS scores of males and females were significantly correlated with indices of actual and desired intimacy; however, for females, correlations of FIS scores with desired intimacy were significantly lower than correlations with actual intimacy. Females who were no longer in the dating relationship at the 6-month follow-up had higher FIS scores than those who were continuing in their dating relationship. These findings increase our understanding of fear of intimacy, especially gender differences in dating couples.     

氯氮平治疗海洛因戒毒后心理渴求疗效观察

目的：对戒毒后的海洛因依赖患者进行氯氮平治疗,观察其对心理渴求的效果。方法：43例自愿戒毒海洛因依赖患者,脱毒后由患者自愿选择氯氮平或纳曲酮治疗,使用自拟的心理渴求量表评定患者治疗前后渴求程度变化。结果：经氯氮平治疗3月后,患者心理渴求评分较疗前有明显降低,有效率65．2％;而纳曲酮组治疗前后改变不明显,有效率为20．0％。结论：氯氮平对海洛因依赖患者的心理渴求可能是具有较好的疗效。     

曲唑酮治疗海洛因戒断症状临床研究

目的：观察曲唑酮对海洛因依赖稽延性戒断症状的疗效。方法：采用双盲对照法，用曲唑酮或安慰剂分别治疗海洛因依赖临床脱毒后存在的稽延性戒断症状的患者。结果：曲唑酮较安慰剂能明显减轻患者的稽延性戒断症状、情绪障碍及对毒品的心理渴求，且无严重不良反应。结论：曲唑酮对海洛因依赖稽延性戒断症状有效。     

Opioid addiction: P300 assessment in treatment by methadone substitution]

The aim of this study was to assess cognitive functions in two clinical conditions, namely during heroin detoxification and during substitution treatment by methadone. Two groups of chronic heroin user inpatients, meeting DSM-III-R criteria for concurrent opiate dependence, were tested using an auditory oddball paradigm of P300. The first group (four women and six men) were drug-free and the second (five women, ten men) received methadone treatment. Patients were also compared to a control group of non-dependent healthy subjects (five women, nine men). The patients were recorded 6-10 days after the beginning of either detoxification or methadone treatment. There were significant P300 alterations in the two patient groups, with amplitude decrease and latency increase, at a time when self-reported signs of withdrawal were absent or minimal. Paradoxically, the reaction time was accelerated in the two groups of patients, who also showed increased discrimination errors. These abnormalities were found with a lesser degree in the methadone-treated group than in detoxification patients.     

Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients

BACKGROUND: The aims of this study were to test the validity, test-retest reliability, and internal consistency of Turkish version of FIS; the variables affecting FIS score. MATERIALS AND METHODS: 71 MS patients and 68 healthy subjects were included to the study. RESULTS: Total FIS score and subscale scores were different statistically between MS patients and healthy volunteers in both first and second FIS applications (p<0.001). These results showed that FIS is validated in divergent direction. BDI score was higher in MS patients than healthy volunteers (p<0.001). There was no statistically significant difference between two study groups for cognitive subscale scores, after the effect of depression was eliminated (p>0.05). To assess the test-retest reliability, the scores of two FIS applications did not differ statistically (cognitive t=1.948 p>0.05, physical t=1.420 p=0.160, social t=1.470 p=0.146, total t=1.990 p=0.05). Intraclass correlation coefficients were 0.89 (99% confidence interval: 0.79-0.94) for cognitive, 0.95 (0.91-0.97) for physical, 0.91 (0.83-0.95) for social, and 0.93 (0.86-0.96) for total FIS scores (p<0.001). EDSS correlated with physical subscores in both applications of FIS. CONCLUSION: Turkish version of FIS, which is valid and reliable, seems an appropriate tool for the assessment of the effects of fatigue in Turkish MS population.