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目的:通过比较在苯丙胺类中枢兴奋剂和氯胺酮混合滥用者与相应单一药物滥用者之间所表现的精神症状的差异,推测两者在诱导精神症状方面的相互作用。方法:对2010年1月至2011年12月华中科技大学同济医学院附属精神卫生中心成瘾病房收治的苯丙胺类中枢兴奋剂,氯胺酮,及其混合滥用所致的精神障碍的患者的病例资料进行回顾性分析,分组别对患者入院时BPRS评定数据进行统计学分析。结果:(1)以氯胺酮为主的混合滥用组在焦虑抑郁因子分和活力缺乏因子分显著高于苯丙胺类中枢兴奋剂为主的混合滥用组(P<0.001),而在激活性因子分,思维障碍因子分,和敌意猜疑因子分显著低于苯丙胺类中枢兴奋剂为主的混合滥用组(P<0.001)。(2)以苯丙胺类中枢兴奋剂为主的混合滥用组在焦虑抑郁因子,活力缺乏因子分显著高于苯丙胺类兴奋剂单一滥用组;(3)以氯胺酮为主的混合滥用组BPRS总分,思维障碍因子,激活性因子,敌对猜疑因子分均显著高于氯胺酮单一滥用组。结论:氯胺酮可能加重苯丙胺类兴奋剂滥用者抑郁,失活性症状;苯丙胺类兴奋剂可能加重氯胺酮滥用者思维障碍,激活性和猜疑敌意,但可以减弱失活性症状,这提示苯丙胺类兴奋剂和氯胺酮所导致的精神症状可能存在不完全相同的精神病理学的机制。
OBJECTIVE: To speculate on the interaction between the psychotropic symptoms induced by amphetamine-type stimulants and ketamine abusers and the corresponding single drug abusers by comparing their differences in psychiatric symptoms. Methods: From January 2010 to December 2011 Huazhong University of Science and Technology, Tongji Medical College Affiliated Mental Health Center addiction ward admitted amphetamine center stimulants, ketamine, and their mixed abuse of patients with mental disorders data Retrospective analysis, grouping did not statistically analyze the BPRS data at admission. Results: (1) The ketamine-based mixed abusers had significantly higher rates of anxiety, depression and vitality deficiencies than mixed amphetamine-based stimulants (P <0.001). However, (P <0.001) were significantly lower than those of the amphetamine-type central stimulants in the scores of thinking disorder factor and hostile suspicion factor. (2) The mixed abusers with amphetamines-based stimulants were significantly more anxiety and depression factor than those with amphetamine-type stimulants alone. (3) The total score of BPRS in ketamine-based mixed abusers was significantly higher than that of single amphetamine- The factors of thinking disorder factor, activating factor and hostile suspicion factor were significantly higher than that of ketamine single abuse group. CONCLUSIONS: Ketamine may aggravate depression and inactivation of amphetamine-type stimulants abusers; amphetamine-type stimulants may aggravate thinking disorders, activation and suspicion of hostility among abusers of ketamine but diminish inactivity symptoms, suggesting that amphetamine-type stimulants and ketamine The resulting psychiatric symptoms may have different mechanisms of psychopathology.