心理干预对酒依赖患者焦虑抑郁情绪的影响

目的探讨心理干预对酒依赖患者焦虑抑郁情绪的影响。方法对200例酒依赖患者采用焦虑自评量表、抑郁自评量表进行焦虑抑郁状态筛查,共筛查出合并焦虑抑郁状态者120例,随机分为干预组80例和对照组40例,两组均予安定替代治疗缓解症状,干预组在此基础上联合心理干预治疗,观察8周,采用焦虑自评量表、抑郁自评量表评定焦虑抑郁状态,对评定结果进行对比分析。结果干预组心理干预后焦虑自评量表、抑郁自评量表评分均较心理干预前有显著下降,且均显著低于对照组（P〈0.01）。结论酒依赖患者有严重的焦虑抑郁障碍,心理干预能有效减轻酒依赖患者的焦虑抑郁情绪,提高生活质量,缓解患者对酒的渴求及心理依赖,避免复饮。     

渐进式肌肉放松训练对酒依赖患者戒断期心理渴求和焦虑的作用

目的:探讨渐进式肌肉放松训练对酒依赖患者戒断期心理渴求以及焦虑的影响。方法:选取符合DSM-IV诊断标准的酒依赖男性患者39例,随机分为干预组(n=20)和对照组(n=19),在常规治疗的基础上干预组行渐进式肌肉放松训练30 min,对照组听30 min非干预性的音乐。用视觉模拟标尺和皮肤电阻值评估患者暴露酒精相关线索时的心理渴求与焦虑情况。结果:干预组和对照组干预后皮肤电阻值(1.80±0.82 vs.3.30±1.34;F=4.59,P=0.04),焦虑(1.97±1.82 vs.2.23±1.79,F=6.09,P=0.01)差异有统计学意义;可视渴求量表(1.99±0.60vs.2.60±0.67,F=1.33,P=0.26),收缩压(123.50±15.57 vs.127.58±9.05,F=2.81,P=0.10),舒张压(87.65±10.02 vs.84.10±12.49,F=1.97,P=0.17)及心率(80.85±2.51 vs.85.16±2.53,F=0.23,P=0.64)差异均无统计学意义。结论:渐进式肌肉放松训练可降低酒依赖患者线索暴露后的心理渴求程度,并可减轻焦虑。     

酒依赖患者的心理状况及心理干预的影响

目的：探讨酒依赖患者的心理状况及护理干预的影响。方法：对60例酒依赖患者心理状况进行分析并对其进行4周有计划的心理干预,采用症状自评量表（SCL-90）在干预前后进行测试。结果：心理干预前除恐怖因子外,其余各因子及总分、总均分显著高于常模（P〈0．05-0．001）,其中抑郁、焦虑、敌对、偏执4个因子分极其显著高于常模（P〈0．001）。心理干预后除恐怖因子外,其余各因子分及总分、总平均分较干预前显著下降（〈0．05-0．01）,其中躯体化、抑郁、焦虑、敌对、偏执5个因子分及总分、总平均分有非常显著下降（P〈0．01）。但心理干预后,人际关系、抑郁、焦虑、敌对、偏执5因子仍然显著高于常模（P〈0．05-0．01）。结论：酒依赖患者存在人格偏离,及早对酒依赖患者实施心理干预为主的综合护理,对促进酒依赖患者消除其心理依赖,防止再次滥用十分必要。     

度洛西汀治疗慢性酒依赖伴抑郁的临床疗效研究

目的：探讨度洛西汀在慢性酒依赖伴抑郁患者中的临床疗效及安全性。方法：将符合条件的66例慢性酒依赖伴抑郁患者随机分成两组,分别给予度洛西汀联合常规戒酒治疗（研究组）和常规戒酒治疗（对照组）,进行8周的系统治疗,使用HAMD（汉密尔顿抑郁量表）,HAMA（汉密尔顿焦虑量表）,CGI（临床疗效总体评估量表）,饮酒渴求度评估其疗效;以 TESS （副反应量表）和有关的实验室检查评定药物副反应。结果：治疗以后,研究组与对照组相比较,研究组第1、2、4、8周 HAMD-17、HAMA 、CGI 评分明显下降（P〈0.05或 P〈0.01）;与对照组相比,研究组第1、2、4、8周的饮酒渴求度明显降低（P〈0.05或 P〈0.01）。结论：度洛西汀治疗酒依赖伴抑郁安全有效,并能明显降低酒依赖患者的心理渴求。     

团队心理护理结合运动疗法在酒依赖患者治疗中的应用研究

目的：探讨团队心理护理结合运动疗法在酒依赖患者治疗中的临床疗效及其作用机制。方法：选取2020年1月—2021年6月在我院治疗的100例酒依赖患者作为研究对象,采用随机数字表法将其分为对照组（n=50）和联合组（n=50）。对照组采用团队心理护理,联合组采用团队心理护理结合运动疗法,比较两组治疗前后饮酒渴求度（VAS）、酒精依赖程度（CIWA-Ar）及治疗后1个月、6个月复饮率。结果：两组治疗后VAS、CIWA-Ar评分低于治疗前,且联合组低于对照组,差异有统计学意义（P<0.05）;治疗后1个月,联合组复饮率为4%,低于对照组的10%,差异无统计学意义（P>0.05）;治疗后6个月,联合组复饮率为8.0%,低于对照组的26.0%,差异有统计学意义（P<0.05）。结论：团队心理护理结合运动疗法可以更好地减轻患者饮酒渴求度、酒精依赖程度,降低复饮率,改善患者生活质量。     

心理干预对外科手术患者应激反应的影响

目的：探讨心理干预对缓解外科手术患者应激反应的影响。方法：择期手术患者90例随机分成干预组（n=45）对照组（n=45）,对照组仅接受常规的术前护理,干预组在此基础上接受心理干预,比较两组应激反应结果。结果：干预组的焦虑自评量表评分（SAS）、抑郁自评量表评分（SDS）、收缩压、舒张压、心率情况均低于对照组,两组比较差异有统计学意义（P〈0.05）。结论：心理干预可以明显降低外科手术患者术前的应激反应程度,缓解手术患者的负性情绪,帮助其保持较良好的身心状态。     

心理干预对肿瘤放疗的影响

目的通过心理干预增强肿瘤患者对放射反应的耐受性,使患者顺利完成治疗。方法200例患者随机分为干预组和对照组,对照组100例,干预组100例,干预组同时给于心理干预。观察两组放疗期间对药物治疗的依赖及放疗计划完成情况。结果干预组对药物的依赖明显低于对照组（P〈0．01）,放疗计划完成情况明显高于对照组（P〈0．01）。结论通过对放疗患者进行心理干预可以大大降低患者出现放射反应时对药物的依赖,增强放疗效果,增强治疗的依从性,顺利完成治疗计划。     

心理干预和后续照管对海洛因依赖者康复的影响

目的：探讨心理干预和后续照管对自愿戒毒的海洛因依赖者康复的影响。方法：选择90例自愿戒毒的海洛因依赖者作为研究对象，按照住院号顺序随机分为观察组（45例）和对照组（45例）。采用中科院心理所修订的明尼苏达多相人格调查表（MMPI）评定两组不同时期（入组时、出院6个月后）的心理健康状况。两组均进行系统的美沙酮替代治疗，研究组合并心理干预、后续照管。结果：研究组患者出院6个月后复吸率为66．67％，对照组复吸率93．55％，两者比较存在显著性差异（P〈0．01）；出院6个月后研究组MMPI的临床量表Pd、Hs、D、Pt、Hy、Mf、Si的评分均值明显低于对照组（P〈0．01）。结论：对自愿戒毒的海洛因依赖者实施心理干预和后续照管，有助于戒毒者形成健康的生活方式，改善心理异常，降低复吸率。     

线索暴露结合数数法降低酒依赖者线索诱发渴求:一项预实验

目的:初步评估主动数数法和被动数数法对酒依赖者在酒精线索诱发渴求的改善效果.方法:采用随机对照试验方法将酒依赖患者分为对照组(5例)、主动数数法组(6例)和被动数数法组(4例),每组共接受5次* 5分钟饮酒视频暴露.对照组在暴露时不做干预,主动数数法组在此基础上每次暴露时主动数数法治疗,被动数数法组在此基础上被动数数法...     

美沙酮维持治疗中海洛因依赖者心理渴求的研究

目的：探讨海洛因依赖者在美沙酮维持治疗过程中对海洛因心理渴求的程度和发展规律。方法：应用视觉类比量表（VAS）制定心理渴求程度量表对海洛因依赖者在美沙酮维持治疗过程中不同阶段、不同剂量、依从性高低三类情况下对海洛因的心理渴求程度进行调查和比较,应用SPSS13．0进行统计分析结果。结果：美沙酮维持治疗过程中海洛因依赖者VAS评分入组前和入组后有显著性统计学意义差异（P〈0．01）;入组后15天、3个月、6个月、12个月之间差异没有明显统计学意义（P〉0．05）;高依从性组和低依从性组有明显统计学意义差异（P〈0．01）;高、中、低剂量组之间差异没有明显统计学意义（P〉0．05）。结论：海洛因依赖者心理渴求程度在随着美沙酮维持治疗时间的延长而呈下降趋势,其中在治疗初期下降最明显;服药依从性高者心理渴求程度明显低于服药依从性低者;在美沙酮维持治疗过程中美沙酮剂量的高低对海洛因依赖者心理渴求程度影响不明显。     

Tetrodotoxin reduces cue-induced drug craving and anxiety in abstinent heroin addicts

Background

Tetrodotoxin (TTX) is a neurotoxin found in puffer fish and other marine animals. New clinical studies suggest that low-dose TTX can safely relieve severe, treatment-resistant cancer pain. The therapeutic potential of TTX in addiction is supported by studies in laboratory animals. The purpose of this double-blind, placebo-controlled study was to assess the effect of a single intramuscular dose of TTX on cue-induced craving and anxiety in abstinent heroin addicts.

Methods

Forty-five abstinent heroin addicts were randomly assigned to three treatment groups: placebo, 5 µg TTX, or 10 µg TTX. Participants were exposed to a neutral video or a heroin-related video. Craving, anxiety, blood pressure, and heart rate were measured pre- and post-exposure.

Results

Heroin-related cues increased both craving and anxiety and had no effect on blood pressure and heart rate. A single dose of TTX dose-dependently attenuated the increases in craving and anxiety while having no effect on blood pressure or heart rate.

Conclusion

The results suggest that low-dose TTX is acutely effective in reducing cue-induced increases in heroin craving and associated anxiety.     

Mindfulness buffers the effects of cue-induced craving on alcohol demand in college drinkers

Alcohol consumption among young adult college students represents a significant public health problem. The presence of alcohol-related cues in drinkers' environments can trigger powerful alcohol cravings, which may influence drinking outcomes. Less is known about how this cue-induced craving influences behavioral economic demand for alcohol. In addition, research has suggested that trait mindfulness may be an important buffer of the effects of internal states of craving on drinking decisions. Based on this literature, we hypothesized that cue-induced cravings would be associated with increased alcohol demand, an effect that would be attenuated among drinkers who have higher levels of mindfulness. Young adult college student drinkers (n = 69) completed a laboratory-based cue-induced craving assessment, a self-report assessment of trait mindfulness, and an alcohol purchase task. Findings revealed that cue-induced craving was related to higher alcohol demand. Consistent with the study hypothesis, acceptance, a component of mindfulness, buffered the effects of cue-induced craving on alcohol demand. Results raise the possibility that mindfulness-based interventions may be useful in helping disrupt the link between internal states of craving and drinking decisions in young adult college student drinkers.     

Long-term methadone maintenance reduces protracted symptoms of heroin abstinence and cue-induced craving in Chinese heroin abusers

BACKGROUND: Cession of heroin use may be followed by a protracted-abstinence (PA) syndrome consisting of craving, negative mood, and physiological changes. PA symptoms have rarely been compared between drug-free and methadone-maintained former heroin users after similar lengths of heroin abstinence. METHODS: Seventy former heroin users were included in one of four groups: in day 15-45 of methadone maintenance therapy (short-term MMT), in month 5-6 of MMT (long-term MMT), opiate-free for 15-45 days after methadone-assisted heroin detoxification (short-term post-methadone), and opiate-free for 5-6 months after methadone-assisted heroin detoxification (long-term post-methadone). PA symptoms (negative mood, dyssomnia, somatization, and craving), and blood pressure and pulse were assessed pre- and post-neutral videotape and pre- and post-heroin videotape. RESULTS: Dyssomnia and the total PA score were worst in short-term post-methadone participants, mood was best in long-term MMT participants, and cue-induced craving was least severe in long-term MMT participants. Blood pressure and pulse did not differ across groups. CONCLUSIONS: Even after acute withdrawal, the first months of heroin abstinence after methadone-assisted detoxification may be more difficult in terms of cue-induced craving and other PA symptoms than the first months of heroin abstinence during MMT. Our findings add to the literature supporting MMT for prevention of cue-induced heroin craving.     

A nicotine antagonist, mecamylamine, reduces cue-induced cocaine craving in cocaine-dependent subjects.

We have previously shown that nicotine enhances cue-induced cocaine craving. In the present study, the effects of a nicotine antagonist, mecamylamine, on cue-induced cocaine craving were investigated. Twenty-three cocaine-dependent patients, all cigarette smokers, were randomly assigned to mecamylamine (2.5 mg tablet) or placebo in a single-dose, placebo-controlled, crossover, double-blind study. Craving and anxiety were measured before and after cocaine cues with visual analog scales for desire to use cocaine and mood. Skin conductance, skin temperature and heart rate were recorded before and during cocaine cues. Following exposure to cocaine cues, all patients reported an increase in cocaine craving and anxiety relative to the precue measures. Cue exposure also produced an increase in skin conductance and decrease in skin temperature. The cue-induced increase in cocaine craving was reduced, while the cue-induced skin conductance and temperature responses were unaffected, by mecamylamine. These findings show that cue-induced cocaine craving is attenuated by mecamylamine. Further study on the use of mecamylamine in relapse prevention programs are suggested.     

Abnormal pain response in pain-sensitive opiate addicts after prolonged abstinence predicts increased drug craving

Rationale  Craving is a primary feature of opiate addiction and is clinically significant because of its potential to trigger opiate use and relapse. Opiate use can also produce abnormal pain perception. We predicted that for opiate addicts (OAs), there may be an association between these two major features of addiction (drug craving and abnormal pain responses). Objectives  To examine pain responses in abstinent opiate addicts in comparison with healthy controls using a cold-pressor test (CPT) and investigate the correlations of cue-induced drug craving with pain responses. Material and methods  Fifty-four abstinent OAs and 46 healthy subjects participated in the CPT, and the OAs were also exposed to heroin-related cues the day before the pain test. Outcome measures included pain-tolerance time, VAS ratings of pain intensity and distress, and (in the cue-exposure procedure) VAS ratings of heroin craving and anxiety. Results  In the CPT, abstinent addicts showed shorter pain-tolerance time (85.1 ± 14.1 s vs. 133.7 ± 16.7 s, p < 0.05) and higher ratings of pain distress (61 ± 3.2 vs. 45.6 ± 3.2, p < 0.01) compared to healthy controls. When we divided the addicts and controls into pain-sensitive (PS) and pain-tolerant (PT) groups by dichotomizing each group in terms of pain-tolerance time, we again found differences between the two PS groups (37.3 ± 3.5 s vs. 57.4 ± 5.1 s, p < 0.01 for pain-tolerance time; 66.7 ± 3.2 vs. 52.4 ± 3.3, p < 0.01 for distress ratings). For all participants, pain-tolerance time was negatively correlated with VAS ratings for pain intensity and distress. More importantly, the PS addicts reported greater cue-induced craving than the PT addicts (17.8 ± 2.2 vs. 4.5 ± 4.2, p < 0.05). For the addict group as a whole, pain distress (the affective aspect of pain) was positively correlated with intensity of cue-induced craving measured on a different day (r = 0.33, p = 0.01). Conclusions  A hyperalgesic state persists for at least 5 months in abstinent OAs and is predictive of cue-induced craving. Longitudinal research is needed to clarify the direction of causation between hyperalgesia and opiate addiction.     

100例酒滥用与酒依赖者脑CT检查分析

目的··：探讨酒滥用与酒依赖者临床与脑ＣＴ表现。方法··：对２２例酒滥用和７８例酒依赖者与对照组１００例,经颅脑ＣＴ检查,结合临床诊断分析。结果··：２２例酒滥用者ＣＴ中脑萎缩表现有１０例,占４５％。７８例酒依赖者ＣＴ中脑萎缩表现有７８例,占１００％。对照组１００例ＣＴ中脑萎缩表现有２例,占２％。结论··：酒滥用与酒依赖者脑萎缩的程度和临床症状的轻重与饮酒量及饮酒时间呈正相关。     

Diurnal variation in cue-induced responses among protracted abstinent heroin users

Objectives

The physiological and psychological responses to drug cue exposure have been assessed in substance abusers. However, there is no study to demonstrate whether the responses to drug cue exposure are diurnal dependence. The present study was to examine whether there was a variation in drug-related cue reactivity across the diurnal cycle among recently abstinent opiate addicts.

Methods

Four groups of 20 abstinent heroin dependent patients (n = 80) were exposed to both neutral and drug-related videos at four separate times during the day: 8:00, 12:00, 16:00, and 20:00 h. Physiological and psychological responses, including heart rate, blood pressure, heroin craving, and subjective anxiety were assessed before and after each cue exposure.

Results

Drug cue significantly increased craving ratings compared to neutral cues across all the four separate times of day. Drug cue-induced craving was greater in the morning (8:00 am) than noon (12:00 pm), but was similar to evening assessments (8 pm). Drug cues also significantly increased anxiety, which positively correlated with cue-induced craving. Drug cues increased heart rate, systolic and diastolic blood pressures, which were not correlated with cue-induced craving or anxiety. However, no time effects were found on the three physiological measures.

Conclusions

Cue-induced craving could be profoundly affected by the time points of cue exposure, using cue-reactivity paradigm. The relative sensitivity of morning and evening assessments of drug craving suggests a need for replication and further research on mechanisms contributing to these diurnal variations.     

Imaging stress- and cue-induced drug and alcohol craving: association with relapse and clinical implications

Stress- and drug-related cues are major factors contributing to high rates of relapse in addictive disorders. Brain imaging studies have begun to identify neural correlates of stress and drug cue-induced craving states. Findings indicate considerable overlap in neural circuits involved in processing stress and drug cues with activity in the corticostriatal limbic circuitry underlying both affective and reward processing. More recent efforts have begun to identify the relationships between neural activity during stress and drug cue exposure and drug relapse outcomes. Findings suggest medial prefrontal, anterior and posterior cingulate, striatal and posterior insula regions to be associated with relapse outcomes. Altered function in these brain regions is associated with stress-induced and drug cue-induced craving states and an increased susceptibility to relapse. Such alterations can serve as markers to identify relapse propensity and a more severe course of addiction. Efficacy of pharmacological and behavioral treatments that specifically target stress and cue-induced craving and arousal responses may also be assessed via alterations in these brain correlates. [Sinha R, Li C-SR. Imaging stress- and cue-induced drug and alcohol craving: association with relapse and clinical implications. Drug Alcohol Rev 2007;26:25 - 31]     

Using virtual reality to investigate complex and contextual cue reactivity in nicotine dependent problem drinkers

Alcohol and cigarette smoking frequently co-occur among adults in the U.S., resulting in a myriad of deleterious health outcomes. Cue reactivity has been posited as one factor that precludes individuals from overcoming alcohol and nicotine dependency. While cue reactivity studies have focused on the impact of proximal cues on cue reactivity, much less is known about the unique impact of complex and contextual cues. This pilot study compares nicotine and alcohol cue reactivity among a sample of nicotine dependent, daily drinkers (N=21) across neutral, party, and office courtyard virtual reality (VR) contexts embedded with proximal smoking cues to: 1) explore and compare the effects of complex nicotine cues on alcohol cross-cue reactivity between nicotine/alcohol dependent drinkers and nicotine dependent/non-alcohol dependent daily drinkers, and 2) assess the effectiveness of VR for eliciting cue-induced nicotine craving responses using complex nicotine cues. Nicotine dependent/non-alcohol dependent drinkers had significantly lower craving for alcohol in the non-alcohol congruent office courtyard VR scene and there was no difference in the alcohol-congruent party scene when compared to the alcohol dependent group, suggesting that the non-alcohol dependent daily drinking group was more likely to react to contextual cues. Consistent with prior cue reactivity studies, dependent smokers experienced significantly higher craving for nicotine in the VR smoking congruent contexts compared to the neutral contexts; however, nicotine/alcohol dependent participants did not return to baseline craving after exposure to smoking cues. These results suggest substantive differences in the ways that nicotine-dependent, daily alcohol drinkers and nicotine/alcohol dependent drinkers experience craving, whether cross-cue or traditional.     

重要人物参与治疗对酒依赖患者治疗动机的影响

目的：了解酒依赖病人治疗动机情况,比较重要人物参与治疗后酒依赖病人治疗动机改变情况。方法：采用改变阶段及治疗迫切程度量表（SOCRATES）对60例酒依赖患者进行评分,然后随机分成两组,观察组（30人）除了进行常规治疗护理外,还采用重要人物参与治疗的形式;对照组（30人）仅进行常规的治疗护理,其重要人物不参与治疗。三周后对两组的治疗动机进行再评。结果：酒依赖病人的SOCRATES的总分较低,入院时两组动机无显著差异。两周后观察组的SOCRATES总分高于对照组。结论：酒依赖患者的治疗动机普遍较低,重要人物参与治疗后治疗动机得以增强,提高了对治疗的依从性。