阿片成瘾者中的人格障碍问题

本文采用多种人格障碍筛查表对接受戒毒治疗的８０例阿片成瘾者进行了测查。结果显示，各种人格障碍（ｐｅｒｓｏｎａｌｉｔｙｄｉｓｏｒｄｅｒｓ，ＰＤｓ）的现患率为８６％，其中戏剧性ＰＤ、依赖性ＰＤ、回避性ＰＤ和边缘性ＰＤ各分别占４４％、３６％、３５％和７６％。具有统计学意义的多种ＰＤ为：（１）依赖性－回避性（ＯＲ值＝１３．９；９５％可信限范围＝４．５５，４２．８３）；（２）戏剧性－依赖性（ＯＲ值＝２．８；９５％可信限范围＝１．１１，７．２６）；（３）边缘性－戏剧性（ＯＲ值＝５．５；９５％可信限范围＝１．４５，２０．８７）；（４）边缘性－依赖性（ＯＲ值＝３．９；９５％可信限范围＝１．０４，１５．０４）。此结果提示，在阿片成瘾者中存在着各种严重的人格障碍，需要在临床工作中注意进行筛查诊断和必要的治疗

COMORBIDITY OF PERSONALITY DISORDERS IN OPIATE ADDICTS

Background:This study examined the comorbidity of personality disorders (PDs) and opiate dependence, and the extent of active co-occurence of different PDs among opiate addicts in residential treatment. Method: Subjects were 80 consecutive consenting patients admitted into a residential opiate detoxification programme. PDs were measured by the Screening Test for Comorbid Personality Disorders-STCPD(developed in the UK). Results: The prevalence rate of any PD was 86%, while the rates for histrionic, dependent, avoidant and borderline PDs were 44%, 36%,35% and 76% respectively. There was an average number of five comorbid PDs in patients with more than one PD. Significant active co-occurrence of the following pairs of PDs was observed: dependent-avoidant (OR=13.9; 95% CI=4.55, 42.83), histrionic-dependent (OR=2.8; 95% CI=1.11, 7.26), borderline-histrionic (OR=5.5; 95% CI=1.45, 20.87),and borderline-dependent (OR=3.9; 95% CI=1.04, 15.04). Conclusion: The findings reveal substantial degree of comorbidity of PDs among opiate addicts and indicate the need to carry out full diagnostic interviews in patients with a positive screen for personality disorders. Given the high prevalence of positive screen for PDs, such diagnoses will enhance the development of treatment protocols that are responsive to the various features of PDs that could jeopardise favourable treatment outcomes.