トラウマセンターの患者の精神活性物質依存症
C A Soderstrom1, P C Dischinger, G S Smith
1Department of Surgery, R Adams Cowley Shock Trauma Center, Maryland Institute for Emergency Medical Services Systems, Baltimore 21201-1595.
JAMA
|May 27, 1992
まとめ
血中アルコール濃度 (BAC) が高かったり,高かったりしないトラウマ患者には,しばしば精神活性物質使用障害 (PSUD) があります. トラウマ患者のアルコール依存症および他のPSUDの普遍的なスクリーニングは推奨されます.
科学分野:
- トラウマトロジーはトラウマトロジーの治療法です.
- 依存症の精神医学 依存症の精神医学
- 臨床心理学の臨床心理学について
背景:
- 現在の慣行では,トラウマ患者の精神活性物質使用障害 (PSUD) のスクリーニングは,血中アルコール濃度 (BAC) が上昇した患者または薬物スクリーニングが陽性である患者だけに制限されています.
- 本研究では,この選択的スクリーニングアプローチの有効性を評価しています.
研究 の 目的:
- トラウマ患者のPSUDの有病率を,BACレベルに関係なく決定する.
- トラウマ集団におけるアルコール依存症およびその他のPSUDのスクリーニングの診断成果を評価する.
主な方法:
- 成人トラウマ患者は,BAC陰性 (BAC <0) とBAC陽性 (BAC ≥22 mmol/L) の2つのグループに分けられました.
- 精神障害の診断および統計マニュアル,修正第3版 (DSM-III-R) の構造化された臨床面接 (SCI) が,アルコール依存症および他のPSUDの診断に使用されました.
- 患者の人口統計と怪我の状況 (例えば,交通事故の犠牲者) を記録した.
主要な成果:
- トラウマ患者 (68.9%) の有意な割合は,主にアルコール依存症のPSUDと診断されました.
- BAC陽性患者のうち,アルコール依存症の基準を満たした患者は66.7%で,アルコール関連でないPSUDもかなり多かった.
- 注目すべきは,BAC陰性患者の45.8%がアルコール依存症でもあり,両グループの多くの患者がアルコール以外のPSUDを併発しており,これは広範な薬物使用障害を示唆しています.
結論:
- この発見は,トラウマ患者のBACレベルのスペクトル全体にわたるPSUDの高い流行を強調しています.
- BACまたは薬物スクリーンのみに基づく選択的スクリーニングは,かなりの数の薬物使用障害を持つ個人を逃します.
- すべてのトラウマ入院におけるアルコール依存症およびその他のPSUDの普遍的な評価は,包括的な患者ケアに不可欠です.
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