Rosa Díaz Hurtado, Javier Goti, Ernesto Magallón-Neri, Sandra Mateus-Gómez, Daniel Ilzarbe, Josefina Castro-Fornieles
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引用次数: 0
摘要
对于患有药物使用障碍(SUD)和合并病症的青少年,通常会建议他们接受综合治疗。本研究旨在比较两种不同干预方案(综合方案和平行方案)的效果,并调查治疗结果的预测因素。75名患有药物使用障碍和合并症的青少年(13-17岁)被转诊到我们的门诊项目,他们被随机分配到综合治疗组(33人)或平行治疗组(32人)。他们的社会人口学变量、精神病理学、药物使用问题和整体功能分别在基线和治疗开始 12 个月后进行了评估。两种治疗方法都能使多个结果变量(学校、家庭和精神问题的严重程度;整体功能;变化阶段)在治疗前和治疗后发生积极变化。综合治疗在依从性(χ2 = 14.328; p > .001)和基于毒品相关问题严重程度的综合全面测量(χ2 = 8.833, p = .003)方面显示出更好的效果。根据适应性治疗策略,我们为退出平行治疗的患者(n = 12)提供了进入综合治疗的可能性。其中 11 人接受了这一方案,并构成了第三个对比组(平行治疗到综合治疗)。多变量逻辑回归分析表明,综合治疗或平行到综合治疗、内化或混合合并障碍、年龄较大以及法律问题较少的患者获得积极的总体治疗结果的可能性增加。在患有双重障碍的青少年患者中,综合治疗的依从性和总体治疗效果均优于平行治疗。年龄较大和法律问题较少也与积极的总体治疗效果有关。
Integrated vs. parallel treatment in adolescents with substance use and comorbid disorders: A randomized trial.
Integrated treatments are often recommended for adolescents with substance use disorders (SUD) and comorbid pathologies. This study aims to compare the effectiveness of two different intervention programs (integrated and parallel) and to investigate treatment outcome predictors. Seventy-five adolescents (13-17 years old) with substance use and comorbid disorders referred to our outpatient program were randomized to integrated (n = 33) or parallel (n = 32) treatment groups. Their sociodemographic variables, psychopathology, substance use problems, and global functioning were assessed at baseline and 12 months after treatment initiation. Both treatments were associated with positive pre-post changes in several outcome variables (severity of school, family, and psychiatric problems; global functioning; and stage of change). Integrated treatment showed better outcome on adherence (χ2 = 14.328; p > .001) and a composite global measure based on the severity of drug-related problems (χ2 = 8.833, p = .003). Following an adaptive treatment strategy, we offered patients who dropped out of parallel treatment (n = 12) the possibility of entering integrated treatment. Eleven of them accepted and constituted a third comparison group (parallel-to-integrated). Multivariate logistic regression analysis showed that the likelihood of a positive global treatment outcome increased with integrated or parallel-to-integrated treatment, internalizing or mixed comorbid disorders, older age, and fewer legal issues. Integrated treatment showed better adherence and global treatment outcomes than parallel treatment in adolescent patients with dual disorders. Older age and fewer legal issues were also related to a positive global treatment outcome.
期刊介绍:
Adicciones publica artículos originales sobre el tratamiento, la prevención, estudios básicos y descriptivos en el campo de las adicciones, como son las drogas ilegales, el alcohol, el tabaco o cualquier otra adicción, procedentes de distintas disciplinas (medicina, psicología, investigación básica, investigación social, etc.). Todos los artículos son seleccionados después de pasar un proceso de revisión anónimo hecho por expertos en ese tema.