在抑郁症,双相情感障碍和精神分裂症中应对物质使用和精神病理学的挑战
Stefania Chiappini1, Alessio Mosca2, Francesco Semeraro2
1UniCamillus International University of Medical Sciences, Via di S. Alessandro 8, Roma, Italy; Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, AL10 9AB Hatfield, UK.
Comprehensive psychiatry
|July 13, 2025
概括
药物治疗用于双重诊断,涉及物质使用障碍 (SUD) 和精神健康状况,如精神分裂症,抑郁症或双相情感障碍,表现出不同的有效性. 由于共同发生的疾病的复杂性和异质性,个性化方法至关重要.
科学领域:
- 精神病学和药理学 精神病学和药理学
- 成 药物 药物 药物 药物
- 心理健康研究 心理健康研究
背景情况:
- 双重诊断,或同时发生的障碍,涉及管理物质使用障碍 (SUDs) 与心理健康状况一起,如严重抑郁症 (MDD),双极障碍 (BD) 和精神分裂症.
- 综合治疗方法对于同时处理双重诊断患者的物质使用和精神病理学至关重要.
- 双重诊断的复杂性给患者和临床医生带来了重大挑战.
研究的目的:
- 系统地审查和总结有关双重诊断的药理疗法的现有研究.
- 为同时出现的SUD和精神健康障碍的各种治疗方法的有效性提供全面的了解.
- 确定当前研究中的差距以及双重诊断药物治疗中的未来探索领域.
主要方法:
- 系统审查遵循系统审查和元分析 (PRISMA) 准则的首选报告项目.
- 在PROSPERO注册 (CRD 42024500114). 在PROSPERO注册.
- 分析了66篇文章,重点关注精神分裂症,MDD或BD的SUD,检查了各种药物类别和干预措施.
主要成果:
- 阿里皮普拉和克洛扎平在治疗精神病症状和SUD方面表现出有效性,阿里皮普拉因其安全性而备受关注.
- 长效药物可能有助于控制冲动性和精神病症状,减少第一发精神病的复发和再住院.
- 关于同时发生的MDD/BD和SUD的最佳药物治疗的发现是混合的,其有效性取决于组合的心理或特定的SUD治疗.
结论:
- 目前关于双重诊断的药理疗法的证据是混合的,突出显示了对个性化方法的需求.
- 治疗的有效性因特定的精神病理,SUD类型,治疗环境和初级保健目标而异.
- 未来的研究应该优先考虑个性化治疗计划,并探索双重诊断的生物学基础,以开发有针对性的药理干预措施.
相关概念视频
Substance Use Disorders Affecting Sleep
223
Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
Understanding the concepts of physical dependence,...
223
Stress and Mental Health
213
Chronic stress profoundly affects mental health, significantly influencing mood, behavior, and overall quality of life. Research closely links chronic stress with mental health conditions such as depression, anxiety, and substance use disorders. Ongoing exposure to stress can lead to physiological and psychological changes, initiating a cycle of emotional distress and maladaptive coping mechanisms.
Individuals with depression often experience challenges in both their personal and professional...
Individuals with depression often experience challenges in both their personal and professional...
213
Depressive Disorders: Etiology
172
Depressive disorders result from a complex interplay of biological, psychological, and sociocultural factors, each contributing uniquely to the development and persistence of the condition. Understanding these factors provides critical insight into the multifaceted nature of depression.
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
172
Psychological and Sociocultural Causes of Schizophrenia
192
Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
192
Bipolar Disorder
148
Bipolar disorder is a chronic mental health condition marked by significant mood fluctuations, including episodes of mania and depression. Elevated energy levels, heightened mood or irritability, impulsive behavior, reduced sleep needs, rapid speech, racing thoughts, inflated self-esteem, and distractibility characterize mania. Individuals with bipolar disorder often alternate between depressive and manic states, with periods of emotional stability lasting an average of six months to a year.
148
Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders
993
Schizophrenia is a neurodevelopmental disorder whose origins are rooted in complex genetic components. Despite our burgeoning understanding, the pathophysiology of this disorder remains incompletely deciphered.
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
993


