AIMS:People who have experienced adverse childhood experiences (ACEs) are more susceptible to substance use disorder (SUD) and depression. The present study examined depression prevalence in hospitalized patients with SUD and examined the association of individual ACEs with major depression. Depression rates 3 months after discharge were also examined. METHODS:Medical inpatients with SUD were recruited from Temple University Hospital. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) at baseline and 3 months post-discharge. Participants were also assessed using an ACE scale at baseline. RESULTS:Of 79 baseline participants, 48% (38) had moderate to severe major depressive disorder (MDD) with PHQ-9 scores ≥15. Among those with baseline MDD, 38% (9/24) continued to have MDD 3 months post discharge, and 42.9% (12/28) of those without MDD at baseline met criteria at 3 months. Sixty-three percent (50/79) of the participants reported 4+ ACEs at baseline. Two ACEs, Household Incarceration and Household Mental Illness, were significantly associated with having MDD at baseline and 3 months (adjusted mean PHQ-9 total score increase (SE) and p-value: 2.97 (1.35), p < .05; 5.32 (1.37), p < .005, respectively). CONCLUSIONS:In this exploratory study, nearly half of medical inpatients with substance use disorder had moderate to severe major depression, with a similar percentage of participants having MDD as outpatients at 3 months. Approximately two thirds of participants reported four or more adverse childhood experiences at baseline. Inpatient medical hospitalization should be utilized as an opportunity to engage people with SUD in multidisciplinary treatment including psychiatric, trauma informed care, and substance abuse treatment.

译文

目的:经历过不良儿童时期(ACEs)的人更容易患上药物滥用症(SUD)和抑郁症。本研究检查了住院的SUD患者的抑郁症患病率,并检查了个体ACE与严重抑郁症的关联。出院后3个月的抑郁率也进行了检查。
方法:从坦普尔大学医院招募SUD的住院患者。在基线和出院后3个月使用患者健康问卷9(PHQ-9)对抑郁进行评估。在基线时还使用ACE量表对参与者进行了评估。
结果:在79名基线参与者中,有48%(38)患有中度至重度严重抑郁症(MDD),PHQ-9得分≥15。在具有基线MDD的患者中,出院后3个月继续有MDD的比例为38%(9/24),在基线为3个月时没有MDD的患者中有42.9%(12/28)符合标准。百分之六十三(50/79)的参与者在基线时报告了4个ACE。两个ACE,即家庭监禁和家庭精神疾病,与基线和3个月的MDD显着相关(调整后的PHQ-9平均总分增加(SE)和p值:2.97(1.35),p <.05; 5.32( 1.37),p <.005)。
结论:在这项探索性研究中,近一半的药物滥用障碍住院患者患有中度至重度严重抑郁症,在3个月时患有MDD的参与者与门诊患者的百分比相似。大约三分之二的参与者在基线时报告了四个或更多的不良儿童经历。应该利用住院医疗住院作为机会,使SUD患者参与多学科治疗,包括精神病学,创伤知情护理和药物滥用治疗。

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