Aims: The aims were to investigate whether baseline characteristics and problematic substance use were related to change in mental distress over time in patients with substance use disorders during an 18-year period. Method: This was a prospective, longitudinal study of patients followed for 18 years after entering specialised treatment for substance use disorders. A sample of 291 patients was recruited in 1997 and 1998. Mental distress was measured using the Hopkins Symptom Checklist 25 at baseline, and at six and 18 years. Lifetime psychiatric disorders and substance use disorders at baseline were measured using the Composite International Diagnostic Interview, while personality disorders were measured using the Millon Clinical Multiaxial Inventory II. At the six- and 18-year follow-ups, substance use was measured using the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test. Linear mixed model was estimated to assess the overall level of mental distress over 18 years for participants with complete data at baseline (n = 232). Results: In an adjusted model, problematic substance use assessed simultaneously with mental distress, having lifetime affective, anxiety and personality disorder at baseline were associated with greater levels of mental distress over the 18-year period. The change in mental distress from baseline to the six-year, but not to the 18-year, follow-up was significantly larger among females than among males. Conclusion: The results suggests a reciprocal relationship over time between substance use and mental health problems. Also, there seems to be an additive effect between ongoing problematic substance use and lifetime mental disorders on greater levels of mental distress. This addresses the importance of integrated treatment for both substance use disorders and mental disorders to improve the long-term course for patients with these comorbid disorders.

中文翻译：

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接受物质使用障碍治疗后 18 年的精神压力水平：一项纵向队列研究

目的：目的是调查基线特征和有问题的物质使用是否与 18 年期间物质使用障碍患者的精神压力随时间的变化有关。方法：这是一项前瞻性纵向研究，对进入物质使用障碍专业治疗后 18 年的患者进行随访。1997 年和 1998 年招募了 291 名患者的样本。在基线、6 岁和 18 岁时使用霍普金斯症状检查表 25 测量精神痛苦。使用复合国际诊断访谈测量基线的终生精神疾病和物质使用障碍，而使用 Millon Clinical Multiaxis Inventory II 测量人格障碍。在 6 年和 18 年的随访中，使用酒精使用障碍识别测试和药物使用障碍识别测试测量物质使用。估计线性混合模型以评估基线时具有完整数据的参与者（n = 232）在 18 年内的整体精神困扰水平。结果：在调整后的模型中，有问题的物质使用与精神困扰同时评估，基线时有终生情感、焦虑和人格障碍与 18 年期间更大程度的精神困扰相关。从基线到 6 年，但没有到 18 年，精神痛苦的变化在女性中明显大于男性。结论：结果表明，随着时间的推移，物质使用与心理健康问题之间存在相互关系。还，持续的有问题的物质使用和终生精神障碍之间似乎存在对更大程度的精神痛苦的累加效应。这说明了对物质使用障碍和精神障碍进行综合治疗以改善这些合并症患者的长期病程的重要性。