A Correlative Study On The Biopsychosocial Factors About Relapse In Heroin Dependents

Objective:The thesis studied on the biopsychosocial factors about relapse in heroin dependents, the biopsychology mechanism of protracted abstinence syndrome(PAS) and the control study about therapeutic effect of quetiapine in treating PAS.Methods:120 heroin dependents and 80 normal controls were involved in the study.All the subjects themselves completed the following questionnaires: general condition questionnair, PWSRS, SCL-90 et al. HAMA and TESS were evaluated by the researcher. By spectrum analysis of heart rate variability(HRV) in heroin dependents with anxiety,there were many parameters, including average HR,SDNN,LF,LF/HF et al. 30 heroin dependents took the quetiapine ,30 heroin dependents took the fuzheng capsule and 30 took no medicine. NE,DA,5-HT were detected before and after the treatment. Utilize t test,u test ,x2 test,Pearson correlation analysis,stepwise and logistic regression analysis to statistic the collected data in SPSS 13.0.Results:(1) The prevalence of anxiety disorder in heroin dependents who had detoxified was 70.67%,the prevalance of personality disorders was 82%.(2)The score of social support in heroin dependents was lower than the normal controls .(3)The scores of somatization,obsession,depression,anxiety,hostility,other factor and the total score of SCL-90 in relapsing heroin dependents were higher than the normal controls and the heroin dependents who was the first time to detoxify. (4)The score of life quality in heroin dependents was lower than the normal controls,the score of life quality in relapsing heroin dependents was lower than the heroin dependents who was the first time to detoxify.(5)The score of HAMA in heroin dependents who used high dose of heroin was higher than the low dose,the score of HAMA in heroin dependents who mixing use heroin was higher than inhaling and injection;the score of HAMA in relapsing heroin dependents was higher than the heroin dependents who was the first time to detoxify; the score of HAMA in long-term dependents was higher than the short-term and mid-term dependents.(6)The scores of PDQ-4+ histrionic type, borderline type ,avoidant type,depressed type were higher in heroin dependents with PAS than those without. (7) SDNN,SDANN,RMSSD,HF in heroin dependents were lower than normal controls, HF,LF,LF/HF in heroin dependents were higher than normal controls;LF/HF in heroin dependents using high dose of heroin was higher than the low dose.(8)5-HT,NE was higher in heroin dependents with PAS than those without. (9) After theropy,the scores of PWSRS and HAMA decreased in heroin dependents who took the quetiapine,the score declined in heroin dependents who took the quetiapine was larger than heroin dependents who took the fuzheng capsule.(10)The time of using heroin,the avoidant personality disorders, the social support,the HAMA,LF/HF,SCL-90somatization, NE and 5-HT affected the relapse of heroin dependents.Conclusions:There were many kinds of PAS in relapsing heroin dependents who had detoxified.The avoidant personality disorders,the long time of using heroin, low social support, the disorder of autonomic nervous function and NE and 5-HT, and somatization, anxiety, insomnia of PAS were the risk factors of relapse. The autonomic nervous function in heroin dependents was disordered,the function between sympathetic nervous and parasympathetic nervous were overbalanced, parasympathetic nervous function was lower and sympathetic nervous function was relatively higher,HRV can be used to assess the degree of disorder of autonomic nervous function,and forecast the PAS coinciding with it ; The high dose of using heroin, long time of using heroin,high 5-HT, the overbalance of autonomic nervous function, the paranoid personality disorders,bad family relation affected the score of HAMA.Quetiapine can improve the PWSRS and adjust the disorder of DA,NE,5-HT.