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。     

海洛因依赖者MMPI测查结果的聚类分析

海洛因依赖者ＭＭＰＩ测查结果的聚类分析广西龙泉山医院（５４５００５）覃圣民为了解海洛因依赖者这一特殊群体的人格特征，本文采用ＭＭＰＩ对３０例男性海洛因依赖者进行了测试，现将结果报告如下。了资料与方法１．１资料来自本院戒毒科３０例男性海洛因依赖者。年龄...     

男性海洛因依赖者雄激素与性欲关系研究

男性海洛因依赖者雄激素与性欲关系研究黎雪松陈志锐罗伟森李崇勇海洛因依赖者绝大部分甚至全部存在性功能障碍。为了解其性激素水平是否有所改变，海洛因对性激素分泌是否存在影响，我们为此对男性海洛因依赖患者展开研究。对象为１９９６年４～６月间来我院的自愿戒毒者...     

海洛因依赖所致性功能障碍104例分析

目的：了解海洛因依赖引起性功能障碍的情况。方法：对１０４例男性海洛因依赖者作临床调查分析。结果：长期使用海洛因可致性功能障碍,性欲减退者达１００％。结论：海洛因依赖可显著引起性功能障碍。     

家庭暴力施暴者的社会支持和家庭功能

目的探讨家庭男性躯体施暴者的社会支持和家庭功能,为进一步干预家庭暴力提供帮助。方法采用病例对照研究,对156例社区家庭男性躯体施暴者和44例社区正常对照组用社会支持量表和家庭功能问卷进行评定。结果家庭暴力男性躯体施暴者主观支持、客观支持、支持利用度和社会支持总分显著低于对照组(P<0.05);他们父亲的惩罚、严厉,过分干涉,拒绝、否认和过分保护养育方式分值显著高于对照组(P<0.05)。结论家庭暴力男性躯体施暴者有较少的社会支持和较多家庭功能问题。     

海洛因依赖者认知功能障碍的WCST对照研究

目的 采用威斯康星卡片分类测验(Wisconsin Card Sorting Test, WCST)分析海洛因依赖者认知功能损害情况.方法 分别对60例住院脱毒治疗的海洛因依赖者与40例正常对照者进行WCST测验.结果 与正常对照相比,海洛因依赖组WCST的总应答数(100.6±20.2)、完成分类数(5.4±1.4)、概念化水平百分数(87.9±13.0)%等测验值均较正常组差(海洛因依赖组60例,正常对照组40例,P<0.05);男女海洛因依赖者WCST测验结果无显著差异;相关性分析发现海洛因依赖者年龄、受教育年限、用毒品年限、每日使用量与WCST测验结果之间没有显著相关性.结论 海洛因依赖者存在认知功能损害,应对海洛因依赖者进行系统的康复治疗改善其认知功能预防复发.     

男性海洛因与甲基苯丙胺依赖者心理渴求及影响因素分析

目的:探讨男性海洛因和甲基苯丙胺依赖者心理渴求及其影响因素。方法:采用一般状况量表(包含人口学信息和毒品使用情况)、药物渴求问卷对住院戒毒的男性海洛因依赖者(海洛因组,157例)及甲基苯丙胺依赖者(甲基苯丙胺组,140例)进行调查和分析。结果:甲基苯丙胺组戒毒时长明显长于海洛因组[(15.61±6.32)d vs(13.85±6.02)d,P0.05];协方差分析显示,甲基苯丙胺组渴求总分及毒品影响和渴求频率分明显高于海洛因组[(38.96±5.64)vs(36.89±8.03),(19.27±3.98)vs(18.05±5.04),(13.79±3.15)vs(12.55±4.24);P均0.05];多元逐步回归分析结果显示,使用毒品时间、频率、种类及就业状况(β=0.261,0.230,0.190,-0.125)进入方程(P均0.05)。结论:男性甲基苯丙胺依赖者心理渴求水平高于海洛因依赖者;心理渴求程度与使用毒品时间、频率、吸食毒品种类及就业状况等因素有关。     

海洛因依赖者伪装和制造疾病临床研究(附221例分析)

目的：了解海洛因依赖者在脱毒过程中伪装和制造疾病的原因和临床表现。方法：对符合中国精神疾病分类方案与诊断标准第2版修订本有关诈病诊断标准的海洛因依赖者进行回顾性研究。结果：发现22l例诈病，发生率4．6％，以青年男性、未婚、初中以下文化、无业占多数，吸毒时间长、多药滥用、涉嫌违法犯罪问题者较多。其动机依次是企图逃避法律惩罚、企图提前解除强戒．骗取成瘾药物、受人唆使胁迫等。方式有说谎、伪装、造伤等。结论：海洛因依赖诈病者较多，应引起注意。     

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。     

海洛因依赖者人格特征分析及与首次吸毒年龄的关系

目的分析海洛因依赖者与正常人群的人格特征的不同特点,探讨人格特征与首次吸毒年龄的关系。方法采用气质性格问卷(Temperament and character inventory,TCl)分别对100例海洛因依赖者与88例正常对照者进行人格评定,比较TCI不同维度分在海洛因依赖组和正常对照组之间的差异,并分析首次吸毒年龄与TCI维度分的相关性。结果1)与正常对照组相比,海洛因依赖组的NS和HA得分高于对照组(P<0.05),而海洛因依赖组CO、SD维度得分均数低于对照组(P<0.01)。2)海洛因依赖者的TCI问卷不同维度的得分与首吸年龄无相关性(P>0.05)。结论1)寻求刺激、放荡不羁、冲动、探索、看事情悲观、害怕不确定、易疲劳等是海洛因依赖的易感人格特征,应对这部分人群进行早期干预。2)首次吸毒年龄与TCI的不同人格维度之间无相关性。     

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。     

A randomized controlled trial of the effectiveness of the illness management and recovery program

OBJECTIVE: This study evaluated the effectiveness of the Illness Management and Recovery program implemented in a group format. METHODS: A total of 210 persons with a severe mental illness receiving treatment at rehabilitation centers in the community in Israel were randomly assigned to either the Illness Management and Recovery program or treatment as usual. The Illness Management and Recovery Scale (client and clinician versions) and measures of coping and social support were administered to participants before and after the intervention. RESULTS: Participants in the Illness Management and Recovery program showed significant improvement in knowledge about their illness and progress toward their personal goals compared with those receiving treatment as usual. Clinician ratings also indicated significant improvement in overall outcome for clients in the Illness Management and Recovery program compared with those who received treatment as usual. Significant improvement in coping was found in both groups, and no change in social support was found for either group. CONCLUSIONS: The Illness Management and Recovery program was effective in increasing clients' knowledge of their illness and helping them make progress toward personal goals.     

海洛因成瘾者康复期心理渴求与血皮质醇水平的关系

目的 了解海洛因成瘾者康复期心理渴求及其与血皮质醇水平的关系。方法 采用心理渴求量表对32例康复期海洛因成瘾者心理渴求水平进行测评,同时测定其血皮质醇水平。结果 康复期患者均存在中度以上心理渴求程度(7.06±1.29)分。患者组血浆皮质醇水平(188.00±27.72)ng/ml高于正常对照组(168.20±20.7)ng/ml(t=2.88 P<0.01);其中强渴求组血浆皮质醇水平(196.70±25.63)ng/ml高于正常对照组(t=3.18 P<0.005)及中度渴求组(173.53±24.30)ng/ml(t=2.52 P<0.02);中度渴求组血浆皮质醇水平与正常对照组无显著性差异(t=0.62 P>0.05)。渴求分值与血浆皮质醇水平无明显相关(r=0.147 P>0.05)。结论 康复期海洛因成瘾者均存在较高心理渴求水平及血浆皮质醇水平,高血浆皮质醇水平可能是预示康复期患者高复吸倾向的一种生物学状态标志。     

A program of supported education for adult Israeli students with schizophrenia

This report describes a supported education program (SEP), a novel community-based program of rehabilitation for psychiatric patients, started in Israel in 1999. Objectives, target population and activities are described. In addition, initial findings of two program-related studies are presented. One study explored the relationship of psychological distress with students' coping strategies and perceived social support. The second study is a survey of mental health literacy and attitudes of heads of schools for adult education where the SEP was implemented. Studies' findings suggested a "case for action" with the following objectives: to develop interventions to prevent distress among SEP users, and to enhance mental health knowledge and foster positive attitudes among school personnel aimed at decreasing dropout rates and encourage the utilization of the opportunities provided by SEP.     

Impact of a multimodal rehabilitative intervention on demented patients and their caregivers

Alzheimer's disease is becoming a social, political, and economic issue as a result of both the growing number of people affected and the enormous economic, social, and emotional costs involved in caring for Alzheimer's patients. The aim of this study is to evaluate the effects of a multimodal intervention program for patients with Alzheimer's disease and their caregivers. The study was conducted on a sample of 32 subjects: 16 Alzheimer's patients and their caregivers. The results obtained after the multimodal rehabilitation program showed that the Alzheimer's patients had a more stable cognitive status and improved mood. Regarding the psychoeducational program, the results demonstrate the efficacy of such interventions in terms of increasing and preserving the caregivers' coping skills and enhancing their perception of the value of support groups.     

Personal and social resources and adaptation to chronic vision impairment over time

Objectives: To examine the effect of personal (coping strategies and locus of control) and social resources (family and friendship support) on adjustment to chronic vision impairment in older adults at baseline (rehabilitation service application), 6 months, and 18 months later.

Method: 313 community dwelling, English speaking older adult applicants to a vision rehabilitation agency in the northeast were interviewed in their homes following informed consent.

Results: A larger portion of variability was accounted for in positive compared to negative outcomes. Greater use of acceptance coping, less use of wishfulness coping, lower endorsement of chance locus of control, and higher family support were associated with better baseline adaptation, yet these predictors had little effect on short- or long-term change in adaptation. Higher friendship support predicted increased adaptation to vision loss at both follow-up points. Friendship support was also associated with decreased depression at Time 3, and lower use of wishfulness was related to decreased depression at Time 2.

Conclusion: Results showed differential effects for positive versus negative outcome variables, short- versus long-term adaptation, personal and social resources, and within social resources, for family versus friendship support.     

蒙古族海洛因依赖者及其配偶的婚姻质量调查

目的调查蒙古族海洛因依赖者及其配偶的婚姻质量状况。方法采用Olson婚姻质量量表(EN-RICH)评定86例蒙古族海洛因依赖者及其非成瘾配偶。结果蒙古族海洛因依赖者及其配偶的婚姻质量明显低于常模,配偶的婚姻质量低于患者。结论蒙古族海洛因依赖者及其配偶的婚姻质量明显降低。患者及配偶双方在婚姻满意度、性格相容性、夫妻交流及解决冲突方式、业余活动、性生活、与亲友的关系等方面均存在不和谐。     

A 33-year follow-up of narcotics addicts

BACKGROUND: This study examined longitudinal patterns of heroin use, other substance use, health, mental health, employment, criminal involvement, and mortality among heroin addicts. METHODS: The sample was composed of 581 male heroin addicts admitted to the California Civil Addict Program (CAP) during the years 1962 through 1964; CAP was a compulsory drug treatment program for heroin-dependent criminal offenders. This 33-year follow-up study updates information previously obtained from admission records and 2 face-to-face interviews conducted in 1974-1975 and 1985-1986; in 1996-1997, at the latest follow-up, 284 were dead and 242 were interviewed. RESULTS: In 1996-1997, the mean age of the 242 interviewed subjects was 57.4 years. Age, disability, years since first heroin use, and heavy alcohol use were significant correlates of mortality. Of the 242 interviewed subjects, 20.7% tested positive for heroin (with additional 9.5% urine refusal and 14.0% incarceration, for whom urinalyses were unavailable), 66.9% reported tobacco use, 22.1% were daily alcohol drinkers, and many reported illicit drug use (eg, past-year heroin use was 40.5%; marijuana, 35.5%; cocaine, 19.4%; crack, 10.3%; amphetamine, 11.6%). The group also reported high rates of health problems, mental health problems, and criminal justice system involvement. Long-term heroin abstinence was associated with less criminality, morbidity, psychological distress, and higher employment. CONCLUSIONS: While the number of deaths increased steadily over time, heroin use patterns were remarkably stable for the group as a whole. For some, heroin addiction has been a lifelong condition associated with severe health and social consequences.     

Psychosocial predictors of cardiac rehabilitation quality-of-life outcomes

OBJECTIVE: This study investigated hostility, social support, coping, depression, and their contributions to concurrent and posttreatment quality of life (QoL) among a group of patients participating in a 6-week cardiac rehabilitation program. METHOD: Both direct and mediational relationships among psychosocial factors, QoL baseline, and QoL outcome were examined using structural equation modeling analysis, while age, education, and severity of illness (risk for future event) were controlled. RESULTS: The final model was well supported (chi(2)=64.88, df=56, P>.05; CFI=.99, RMSEA=.04). Results indicated that baseline QoL, hostility, and depressive symptom severity directly and independently predicted QoL outcome, while depression and hostility were also associated with baseline QoL. Hostility, social support, and maladaptive coping also contributed to baseline and follow-up QoL by their associations with depression. CONCLUSION: Psychosocial characteristics were interrelated, and they predicted postrehabilitation QoL outcome directly or indirectly through depression symptom severity.