有情绪调节困难的美沙酮维持治疗 (MMT) 患者的特征

David Potik, Miriam Adelson, Shaul Schreiber, Einat Peles
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摘要

在接受美沙酮维持治疗(MMT)的阿片类药物使用者中,情绪调节紊乱的情况在一些小型研究中有所报道。我们的目的是评估美沙酮维持治疗中情绪调节能力受损患者的患病率和特征。我们通过情绪调节困难量表(DERS)对 121 名患者进行了横断面抽样调查。我们回顾了临床、社会人口学和成瘾变量的数据,包括阿片类药物、酒精、可卡因、大麻和苯二氮卓(BDZ)的随机观察尿检结果。DERS 高分(90 分)的发生率为 39%。与 DERS 高分相关的特征(逻辑回归模型)是苯二氮杂卓滥用和入院前使用阿片类药物 20 年。在分量表中,IMPULSE 和 STRATEGIES 与药物使用独立相关(逻辑回归)。仅在单变量分析中,可卡因使用率较高。在尿检呈阴性的患者中,DERS 评分与受教育年限成反比。在企图自杀或参与肢体暴力的患者中,DERS 的 "警觉 "子量表得分女性低于男性。由于 "IMPULSE "和 "STRATEGIES "得分可预测药物使用情况,因此在对 MMT 进行第三波认知行为干预时,应首先针对情绪调节的这些方面进行干预。
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Characteristics of Patients in Methadone Maintenance Treatment (MMT) Who Have Difficulties in Emotion Regulation

Disturbances in emotion regulation among opioid users receiving methadone maintenance treatment (MMT) was reported in a few small studies. We aimed to evaluate the prevalence and characteristics of patients in MMT with impaired emotion regulation. We studied a cross-sectional sample of 121 patients by means of the Difficulties in Emotion Regulation Scale (DERS). Data on clinical, sociodemographic and addiction variables were reviewed, including results of random observed urine testing for opioids, alcohol, cocaine, cannabis, and benzodiazepine (BDZ). The prevalence of a high DERS score (> 90) was 39%. Characteristics associated with high DERS scores (logistic regression model) were benzodiazepine misuse and 20 years of opioid use before admission to MMT. Among the subscales, IMPULSE and STRATEGIES were independently related to substance use (logistic regression). Greater cocaine usage was also more prevalent only in univariate analyses. The DERS score correlated inversely with years of education among patients with negative urine test. The DERS subscale score for AWARENESS was lower in females than in males as among patients with suicide attempts or involvement in physical violence. Since the IMPULSE and STRATEGIES scores predict drug use, these aspects of emotional regulation should be targeted first in third-wave cognitive-behavioral intervention in MMT.

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