物质依赖科住院患者逃跑原因分析及其对策

目的:了解精神活性物质所致精神障碍住院患者私逃的特点,并提出相应对策。方法:回顾性分析物质依赖科住院患者中8例逃跑患者的临床资料。结果:外逃者多数为新型非法精神活性物质所致精神障碍患者,私逃时戒断症状已消除或精神病性症状已消失。患者外逃多发生在晚上非正常上班期间,外逃方法多是毁坏病房卫生间窗子后逃跑。患者外逃后大多能及时追回或及时办理自动出院手续,外逃期间未发生严重后果的事件。结论:新型非法精神活性物质所致精神障碍住院患者逃跑发生率较高。私逃原因复杂多样,应采取综合措施防止患者外逃。     

精神分裂症合并多种精神活性物质依赖(缓解期)一例报告

<正>患者男,24 a,未婚,初中文化,无业。因反复滥用K粉、麻古、冰毒4 a,伴乱讲、行为怪异等3 a,于2013年11月24日入院。患者家属诉患者2007年前(约18 a时)在酒吧玩时开始滥用摇头丸(从1粒-3粒·次-1不等),从偶用,娱乐性用,后慢慢开始滥用K粉(每日约鼻吸3 g-5 g,最大量达10 g·d-1),几乎天天吸,持续多年从未间断吸毒,直至被     

苯丙胺类精神活性物质依赖机制的研究进展

新型毒品冰毒、麻谷的主要成分是苯丙胺类精神活性物质(以下简称苯丙胺类物质)的一种-甲基苯丙胺(methamphetamine,MA).甲基苯丙胺是联合国精神药品公约明令管制的精神活性物质,其毒性不仅损伤神经系统,对心血管系统的损害也比较明显,表现为滥用者的心电图异常[1].长期以来,关于苯丙胺类物质的生理依赖问题观点不一,但随着研究的深入,许多学者认为甲基苯丙胺存在着生理依赖.本文就苯丙胺类物质的依赖机制予以综述.     

阿片类物质依赖638例临床分析

本文对因阿片类物质依赖而住入我院戒毒的６３８例患者作了临床分析，男性４９９人，女性１３９人，平均年龄２６．９岁，５９．６％，为个体户，７７．９％病人在一年以上，吸毒品占９７．３％，静脉注射或肌注占２．７％，应用多种疗法均未达消除戒断症状和脱毒的目的，但出院后短期复吸者较多，其中再入院占１７．８％因此，加强心理，治疗和康复治疗的善后照顾对防止复吸有很必要。     

非靶受体在精神活性物质依赖中的作用

当前精神活性物质滥用和成瘾呈上升趋势,它既是一个严重的社会问题,又是一个非常重要的生物学问题。在我国导致精神依赖的活性物质主要是阿片类。精神活性物质作用的靶受体为阿片受体,非靶受体主要包括多巴胺受体、N-甲基-D-门冬氨酸(NMDA)受体和组胺等。本文主要论述NMDA受体和组胺受体等非靶受体在精神活性物质依赖发生发展过程中功能和结构上的变化,探讨精神活性药物成瘾的机制,研究和开发以NMDA和组胺受体为靶标的新药,为阿片类药物成瘾的防治开辟新的研究领域。     

阿片受体固有活性与阿片类物质依赖

阿片类物质依赖作用的机理仍不完全清楚，近年来学术界对阿片受体固有活性与阿片类物质作用的关系表现出很大的兴趣。阿片受体慢性暴露于阿片类物质后固有活性的变化与阿片类物质依赖产生的关系是研究阿片类成瘾机制热点问题之一。     

物质依赖的基因研究进展

物质滥用作为一种复杂的行为疾病 ,它受心理、社会环境及个体遗传因素的综合作用 ,分子生物学研究发现某些特定的基因与物质依赖的发生、发展和戒断症状有关 ,本文就物质依赖基因的研究方法及研究进展综述如下 :一、物质依赖相关基因定位的研究方法自 1 991年色盲基因被定位于 X染色体以来 ,人类疾病的基因定位不断发展 ,如何找到理想的基因克隆方法是疾病基因研究的关键。基因克隆方法从最初的定位克隆 ,发展到现在的表型克隆。(一 )定位克隆的研究方法定位克隆 ,过去称之为逆向遗传学 ,它通过限制性片段长度多态性 ( Restriction Fragme…     

酒依赖和烟草依赖共病的研究进展

酒精和烟草在大多数国家是不受管制的精神活性物质,与阿片类和可卡因等"硬"毒品不同,它们仅被限制使用(成年人才有资格得到它)而并未被社会禁止.因此,它们被不同国家、不同文化背景的人群广泛使用,酒依赖和烟草依赖也就成了最常见的物质使用障碍并导致了大量的医学和社会问题.许多研究显示,一种成瘾物质的使用会增加其他成瘾物质的使用风险,更有许多研究显示,吸烟和饮酒之间有阳性关联.本文就酒依赖和烟草依赖之间的关联特征和可能机制作一综述.     

耳针治疗阿片类物质依赖选穴分析

近年来我国阿片类物质滥用人群有不断扩增的趋势。耳针治疗戒断综合征因其具有简便、经济、无毒副作用、疗效确切 ,易为患者接受等优点 ,自 70年代以来日益受到人们的重视。为探索耳针戒毒选穴规律 ,笔者分析了有关杂志发表的耳针治疗阿片类物质依赖综合征的 1 0个耳穴处方 ,以期总结筛选有效穴位 ,提高耳针戒毒的疗效。一、处方组成及来源近年来文献报道的耳针戒毒处方 1 0个分别为 :1心、肾、内分泌、皮质下、交感、神门、耳廓相应部位〔1〕。 2双肺点 〔2〕。 3双肺点、肾、神门、皮质下〔3〕。 4双交感、神门、肝、肺、肾〔4〕。 5双肺…     

127例酒依赖住院患者脑电图分析

目的：对127例酒依赖住院患者进行脑电图分析。方法：采用南京伟思科技公司生产的VEEG1160A型脑电图仪。按国际10／20系统电极放置法和特殊电极放置，并加用剥夺睡眠诱发实验及反复多次检查。结果：脑电图异常46次／人，异常率为36．2％。脑电图主要表现为慢波化，并以θ及δ波活动占优势，以顶、枕区较明显，额、中央区出现较多不规则β波，以20～21Hz为主。结论：酒精对脑细胞有直接毒性作用，EEG作为研究脑功能的重要手段，是脑细胞功能的最直接反映。     

Personality mediators of psychopathy and substance dependence in male offenders

Psychopathy and substance dependence (SUD) is highly prevalent in incarcerated populations and tends to co-occur in the same individuals. The factors underlying this relationship are not clearly understood. The primary purpose of this study was to investigate whether two personality models mediate the relationship between psychopathy and substance misuse in male offenders. Ninety-two inmates in provincial correctional centers in New Brunswick completed questionnaires, including the Sensitivity to Reward Sensitivity to Punishment Questionnaire to measure behavioral activation and behavioral inhibition, the Substance Use Risk Profile Scale to measure anxiety sensitivity, introversion/hopelessness, sensation seeking and impulsivity, and the Psychopathic Personality Inventory-Revised to assess psychopathy levels. Results revealed that high impulsivity indirectly mediated the relationship between psychopathy and stimulant dependence. In addition, low anxiety sensitivity indirectly mediated the relationship between psychopathy and opioid dependence. Finally, impulsivity indirectly and inconsistently mediated the relationship between psychopathy and alcohol dependence. These results suggest that individuals with psychopathic traits are at increased risk of misusing certain drugs due to underlying personality-based differences.     

An investigation of stigma in individuals receiving treatment for substance abuse

This study examined the impact of stigma on patients in substance abuse treatment. Patients (N=197) from fifteen residential and outpatient substance abuse treatment facilities completed a survey focused on their experiences with stigma as well as other measures of drug use and functioning. Participants reported experiencing fairly high levels of enacted, perceived, and self-stigma. Data supported the idea that the current treatment system may actually stigmatize people in recovery in that people with more prior episodes of treatment reported a greater frequency of stigma-related rejection, even after controlling for current functioning and demographic variables. Intravenous drug users, compared to non-IV users, reported more perceived stigma as well as more often using secrecy as a method of coping. Those who were involved with the legal system reported less stigma than those without legal troubles. Higher levels of secrecy coping were associated with a number of indicators of poor functioning as well as recent employment problems. Finally, the patterns of findings supported the idea that perceived stigma, enacted stigma, and self-stigma are conceptually distinct dimensions.     

Sex modulates approach systems and impulsivity in substance dependence

Background

Personality traits such as pathological engagement in approach behaviors, high levels of impulsivity and heightened negative affect are consistently observed in substance dependent individuals (SDI). The clinical course of addiction has been shown to differ between sexes. For example, women increase their rates of consumption of some drugs of abuse more quickly than men. Despite the potential influence of personality and sex on features of addiction, few studies have investigated the interaction of these factors in substance dependence.

Methods

Fifty-one SDI (26 males, 25 females) and 66 controls (41 males, 25 females) completed the Behavioral Inhibition/Behavioral Activation System (BIS/BAS) Scales, the Barratt Impulsiveness Scale, and the Positive and Negative Affect Schedule (PANAS-X). Data were analyzed with 2 × 2 ANCOVAs testing for main effects of group, sex and group by sex interactions, adjusting for education level.

Results

Significant group by sex interactions were observed for BAS scores [F(1,116) = 7.03, p < .01] and Barratt Motor Impulsiveness [F(1,116) = 6.11, p < .02] with female SDI showing the highest approach tendencies and impulsivity followed by male SDI, male controls, and finally female controls. SDI scored higher on negative affect [F(1,116) = 25.23, p < .001] than controls. Behavioral Inhibition System scores were higher in women than men [F(1,116) = 14.03, p < .001].

Conclusion

Higher BAS and motor impulsivity in SDI women relative to SDI men and control women suggest that personality traits that have been previously associated with drug use may be modulated by sex. These factors may contribute to differences in the disease course observed in male compared to female drug users.     

Retention in substance dependence treatment: the relevance of in-treatment factors

In addition to “fixed” patient demographic and background variables, treatment process constructs play an important role in the prediction of treatment retention in substance dependence treatment. The objective of this paper is to analyze the predictive role of repeated measures of treatment readiness and behavioral intention, and of patients' perception of the therapeutic alliance, while controlling for fixed patient-oriented variables. Ninety-three patients, both alcohol and drug dependents, enrolled in this study, which was conducted in an inpatient treatment setting. Patients completed questionnaires shortly after admission (t=0) and approximately 2 weeks later (t=1). Using these measures, 35% of variance of a length of stay in treatment of up to 30 days could be explained. Fixed patient-oriented variables accounted for 21% of variance. Of the cognitive factors, helping alliance was the most important, accounting for an additional 8% of variance. The implications of these results are discussed.     

Interpersonal violence exposure and alcohol treatment utilization among medical inpatients with alcohol dependence

The goal of this study was to examine the association between interpersonal violence exposure and utilization of alcohol treatment after medical hospitalizations among adults with alcohol dependence. We analyzed data collected from a prospective cohort of 238 adults with alcohol dependence who were inpatients in a large urban hospital. Participants who reported interpersonal violence victimization had 1.6 times the odds (adjusted odds ratio = 1.64, 95% confidence interval = 0.92–2.91) of receiving alcohol treatment during the year after hospitalization compared to participants with no violence exposure. Recent (past 3 months) exposure to violence was not more strongly related to receipt of treatment than any lifetime violence exposure. Results suggest that a history of interpersonal violence victimization may be associated with an increased odds of alcohol treatment utilization following a medical hospitalization. Therefore, clinicians should be optimistic about identifying and referring patients who have experienced interpersonal violence to alcohol treatment. Moreover, given the potentially high prevalence of interpersonal violence exposure among inpatient populations at large urban hospitals, alcohol treatment providers should develop methods to address both alcohol dependence and violence recovery.     

Gender effect on association between DRD2 polymorphism and substance dependence in a Spanish sample

Our aim was to examine a possible association between substance dependence and the TaqIA polymorphism of the D2 dopamine receptor (DRD2), a single nucleotide polymorphism (SNP) located at the 3′ UTR region of the DRD2 gene. A case–control design stratified by gender was used to analyze the genotypes of this SNP in a sample of 125 substance-dependent patients according to DSM-IV and 203 blood donors recruited as controls in two general city hospitals in Madrid, Spain. Genomic DNA from peripheral blood samples was amplified through PCR to identify the variants of the SNP in the DRD2 gene. Analyses performed with Chi² tests revealed that the A1 allele (A1/A1 and A1/A2 genotypes) of the Taq 1A SNP of the DRD2 gene was significantly associated with substance dependence in males, but not in the whole sample. Male patients had significantly higher rates of the A1-containing genotypes than male controls. The finding of an association between substance dependence and the DRD2 gene TaqIA SNP only in males suggests the existence of gender-specific differences in the genetic underpinnings of substance dependence.     

A genome-wide search for quantitative trait loci influencing substance dependence vulnerability in adolescence

This study describes results from a genome-wide search for quantitative trait loci (QTL) influencing substance dependence vulnerability in adolescence. We utilized regression-based multipoint (and single-point) QTL mapping procedures designed for selected sibpair samples. Selected sibling pairs included 250 proband-sibling pairs from 192 families. Clinical probands (13–19 years of age) were drawn from consecutive admissions to substance abuse treatment facilities in the Denver metropolitan area; siblings of probands ranged in age from 12 to 25 years. In addition to the selected sample, a community-based sample of 3676 adolescents and young adults were utilized to define a clinically-significant, heritable, age- and sex-normed index of substance dependence vulnerability—a priori and independent of our linkage results. Siblings and their parents were genotyped for 374 STR micro-satellite markers distributed across the 22 autosomes (average inter-marker DISTANCE=9.2 cM). Non-parametric single-point linkage results indicated 17 markers on 11 chromosomes with nominally significant tests of linkage; six markers with LOD scores greater than 1.0 and one marker (D3S1614) with a LOD score of 2.2. Multipoint mapping corroborated two locations and provided preliminary evidence for linkage to regions on chromosome 3q24-25 (near markers D3S1279 and D3S1614) and chromosome 9q34 (near markers D9S1826 and D9S1838).     

我院住院患者抗菌药物应用分析

目的：了解我院住院患者抗菌药物的应用情况,评价抗菌药物应用合理性,为进一步干预提供理论依据。方法对2014年1～3月我院3712份出院病历抗菌药物临床应用进行统计分析。结果我院抗菌药物临床应用存在不合理现象,主要表现在用药指征的掌握、给药方法和给药时间间隔不合理等。结论我院应进一步加强抗菌药物应用管理,提高合理用药水平。     

Further evidence of differences in substance use and dependence between Australia and the United States

The current study compared the prevalence of substance use and DSM-IV dependence in the USA and Australia. Participants aged 18–54 were selected from two cross-sectional nationally representative Australian (National Survey on Mental Health and Well-Being – NSMHWB, 1997, n = 7570) and American (National Epidemiologic Survey on Alcohol and Related Conditions – NESARC, 2001–2002, n = 29,673) household surveys. The NSMHWB utilised the Composite International Diagnostic Interview, whereas the NESARC used the Alcohol Use Disorder and Associated Disabilities Interview Schedule. The 12-month prevalence of alcohol use was lower in the USA (56.5%) than in Australia (77.2%), although the rates of alcohol dependence were similar in both countries. The USA had higher rates of alcohol dependence conditional on use (9.0%) compared to Australia (6.8%). Australians had higher levels of drug use, dependence, and conditional dependence than Americans (except for sedatives and opioids). The absence of significant interactions between country of interview and the common correlates of substance use disorders indicated that the influence of these factors was similar in the USA and Australia. In conclusion, the current investigation revealed striking differences in the rates of conditional drug dependence between Australia and the USA. The cross-national generalizability of the relationships between the common correlates and prevalence of substance use and dependence indicates that a similar process of vulnerability to dependence may be operating in the USA and Australia. In the future, these cross-national differences could be used to help better understand the factors that influence drug use and the development of dependence.