Abstract

Background

Depressive symptoms are common during abstinence from psychoactive substances. Research caveats limit the study of persistence of significant depressive symptoms beyond four weeks of abstinence. This prospective study examined the course and correlates of depressive symptoms in patients with alcohol or opioid use disorder over 5-8 weeks.

Methods

Sample consisted of 100 men randomly selected out of 307 inpatient men with either alcohol or opioid use disorder. Weekly assessments focused on depressive symptoms (HDRS, BDI), and their correlates (HAM-A for anxiety symptoms, CIWA-Ar and COWS for withdrawal symptoms, OCDS and OCDUS for craving for alcohol and opioids respectively). Other correlates assessed were severity of dependence and family support. PRISM (Psychiatric Research Interview for Substance and Mental disorders) was used for diagnosis of substance-induced depression and major depressive episode. Repeated measures ANOVA was used for weekly comparison of depressive symptoms.

Results

Participants were dependent on opioids (56%), or alcohol (41%), or both (3%). Mean age was 33.5 years. Eighty-eight participants completed the study. Substance-induced depressive episode was diagnosed by PRISM in 59% participants. Weekly assessments of depressive symptoms recorded significant reductions (p < 0.0001; Wilk’s Lambda for HDRS and BDI 137.01 and 105.4 respectively). Baseline depressive symptoms correlated significantly with anxiety, withdrawal symptoms, and negatively with social support. No participant was diagnosed with a major depressive episode at 6-8 weeks.

Conclusion

Depressive symptoms in early alcohol or opioid abstinence resolve significantly over a month; therefore, clinicians should exercise watchful waiting before starting antidepressant therapy.

中文翻译：

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早期酒精或阿片类药物戒断中的抑郁症状：过程和相关性

摘要

背景

在戒除精神活性物质期间，抑郁症状很常见。研究警告限制了对超过 4 周禁欲后显着抑郁症状持续存在的研究。这项前瞻性研究检查了 5-8 周内酒精或阿片类药物使用障碍患者抑郁症状的过程和相关性。

方法

样本包括从 307 名患有酒精或阿片类药物使用障碍的住院男性中随机选择的 100 名男性。每周评估侧重于抑郁症状（HDRS、BDI）及其相关因素（HAM-A 表示焦虑症状，CIWA-Ar 和 COWS 表示戒断症状，​​OCDS 和 OCDUS 分别表示对酒精和阿片类药物的渴望）。评估的其他相关因素是依赖的严重程度和家庭支持。PRISM（物质和精神障碍的精神病学研究访谈）用于诊断物质诱发的抑郁症和重度抑郁症发作。重复测量方差分析用于每周比较抑郁症状。

结果

参与者依赖阿片类药物（56%）或酒精（41%），或两者兼有（3%）。平均年龄为 33.5 岁。八十八名参与者完成了这项研究。PRISM 在 59% 的参与者中诊断出物质引起的抑郁发作。每周对抑郁症状的评估记录显着减少（p < 0.0001；HDRS 和 BDI 的 Wilk's Lambda 分别为 137.01 和 105.4）。基线抑郁症状与焦虑、戒断症状显着相关，与社会支持呈负相关。没有参与者在 6-8 周被诊断出患有重度抑郁症。

结论

早期戒酒或阿片类药物戒断时的抑郁症状会在一个月内显着缓解；因此，临床医生在开始抗抑郁治疗前应谨慎等待。