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目的了解美沙酮维持治疗(MMT)者的抑郁现状,以及其他因素对抑郁发生的影响。方法以219名自愿参加MMT的海洛因成瘾者为研究对象,采用自制问卷调查美沙酮维持治疗者的抑郁情况。将抑郁作为应变量,构建非条件Logistic回归模型进行多因素分析相关影响因素。结果 (1)共调查广州市MMT者218例,检出有抑郁症状者92例,检出率为42.20%。(2)单因素分析结果:教育程度(χ~2=3.33,P<0.1)、月收入(χ~2=4.62,P<0.1)、工作情况(χ~2=4.40,P<0.1)、感染艾滋病病毒(HIV)情况(χ~2=3.03,P<0.1)、有无注射吸毒(χ~2=2.93,P<0.1)、生活满意度(χ~2=0.08,P<0.1)、生活态度(χ~2=4.74,P<0.1)、社会支持度(χ~2=13.85,P<0.1)、正向(χ~2=7.46,P<0.1)和负向(χ~2=63.75,P<0.1)生活情绪,均会对MMT者抑郁产生影响,差异有统计学意义。其他社会人口学特征、药物滥用史和社会心理因素,对抑郁影响均无统计学意义。(3)应用逐步法进行筛选,最终进入模型的变量为月收入和正负向情绪。结论广州市MMT者抑郁患病率较高,低于吸毒人群但高于正常人群;教育程度、月收入、工作情况、HIV感染情况、注射吸毒、生活满意度、生活态度、社会支持度、正向负向情绪,是可能影响抑郁的因素。低收入者为抑郁的高危人群。在治疗过程中通过医师、患者和社会三方面合作共同努力,改善患者生活情绪,可预防抑郁的发生,降低MMT者复吸率。
Objective To understand the status of depression in methadone maintenance therapy (MMT) and the influence of other factors on depression. Methods A total of 219 heroin addicts who volunteered to participate in MMT were enrolled in this study. The self-made questionnaires were used to investigate the depression status of methadone maintenance treatment. Depression as a dependent variable, build unconditional Logistic regression model for multivariate analysis related factors. Results (1) A total of 218 MMT patients were surveyed in Guangzhou. 92 cases with depressive symptoms were detected, the detection rate was 42.20%. (2) The results of univariate analysis showed that educational level (χ ~ 2 = 3.33, P <0.1), monthly income (χ ~ 2 = 4.62, P < (Χ ~ 2 = 3.03, P <0.1), whether there was any drug use or not (χ ~ 2 = 2.93, P < (Χ ~ 2 = 4.74, P <0.1), social support (χ ~ 2 = 13.85, P <0.1) 63.75, P <0.1). All of them have an effect on the depression of MMT, the difference was statistically significant. Other socio-demographic characteristics, history of drug abuse and psychosocial factors had no significant effect on depression. (3) The application of step by step screening, the final model to enter the monthly income and positive and negative emotions. Conclusions The prevalence of depression in Guangzhou MMT patients is higher than that in the drug users but higher than that in the normal population. The level of education, monthly income, work status, HIV infection, drug abuse, life satisfaction, life attitude, social support, positive Negative emotions are factors that may affect depression. Low-income people are at high risk of depression. In the course of treatment, through the joint efforts of doctors, patients and the community, we can improve the mood of patients, prevent the occurrence of depression and reduce the relapse rate of MMT.