抗抑郁药与酒精使用障碍:一项关于抑郁症状变化的中介作用的多中心研究。

IF 3 Q2 SUBSTANCE ABUSE
Joshua Jaeger, Lara Osterburg, Maria Stein, Miranda Germann, Sara A. Lustenberger, Alexander Wopfner, Niklaus Denier, Tobias Bracht, Franz Moggi, Leila M. Soravia
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引用次数: 0

摘要

背景:酒精使用障碍(AUD)和抑郁症的发病率很高,并对心理、生理、社会和经济造成严重后果。由于抗抑郁药物对 AUD 治疗结果的影响仍不明确,因此这两种疾病的共存给临床带来了复杂的挑战。在这项多中心纵向研究中,我们调查了抗抑郁药物治疗与 AUD 患者抑郁症状和饮酒量变化之间的关系:我们分析了 2015 年至 2019 年期间参加为期 12 周住院治疗项目的 153 名戒毒 AUD 患者的数据。在中介分析中,我们采用引导法和准贝叶斯框架,估算了抗抑郁药物对戒酒天数百分比的总效应、直接效应和中介效应,以评估抑郁症状变化作为中介因素的作用:中介分析显示了一个双重影响路径模型,即抗抑郁药对戒断的直接影响为负数(p = 0.004),而通过抑郁症状的减轻而产生的间接影响为正数(p = 0.002):中介分析结果表明,接受抗抑郁药物治疗的患者,如果抑郁症状长期得不到改善,复发率会更高,而接受抗抑郁药物治疗的患者,如果抑郁症状得到缓解,复发率会更低。因此,为了优化治疗效果,在 AUD 治疗期间使用抗抑郁药时,应密切监测抑郁症状。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Antidepressants and alcohol use disorder: A multicenter study on the mediating role of depression symptom changes

Antidepressants and alcohol use disorder: A multicenter study on the mediating role of depression symptom changes

Antidepressants and alcohol use disorder: A multicenter study on the mediating role of depression symptom changes

Background

Alcohol use disorder (AUD) and depression are highly prevalent and tied to significant psychological, physiological, social and economic consequences. Their co-occurrence presents a complex clinical challenge, as the impact of antidepressant medication on AUD outcomes remains equivocal. In this multicenter, longitudinal study we investigated the relationship between antidepressant medication and changes in depression symptoms and alcohol use in AUD patients.

Methods

We analyzed data from 153 detoxified AUD patients who attended a 12-week residential treatment program between 2015 and 2019. Within a mediation analysis, adopting a bootstrapping approach and a quasi-Bayesian framework, we estimated the total, direct, and mediated effects of antidepressants on the percentage of days abstinent to assess the role of changes in depression symptoms as a mediating factor.

Results

The mediation analysis revealed a dual impact pathway model with a negative direct effect of antidepressants on abstinence (p = 0.004) and a positive indirect effect, mediated through the reduction of depression symptoms (p = 0.002).

Conclusions

The findings of the mediation analysis show that patients treated with antidepressants and whose depression symptoms do not improve over time show more relapses, while patients treated with antidepressants who achieve a reduction in depression symptoms show fewer relapses over time. Thus, to optimize treatment outcome, depression symptoms should be vigilantly monitored when antidepressants are prescribed during AUD treatment.

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