A Primary Evaluation On Relapse Prevention Of Psychological Intervention In Community Rehabilitation

ObjectivesTo evaluate the differences of relapse rate, anxiety, depression, psychological craving, pain degree, protracted withdrawal symptoms, addiction severity index, health status, the frequency and severity of adverse events between the two groups by repeated measurement and group comparison, to primary evaluate the prevention effect of relapse of psychological intervention in the community rehabilitation treatment.Methods and ContentsA repeated measured and controlled cohort study was conducted.374drug addicts were collected from12areas in Shanghai and divided into two groups:206in comprehensive group and168in pure group. Comprehensive group took Jitai tablets and received psychological intervention and social support treatment. Pure group took Jitai tablets and received social support treatment. Physical examinations, laboratory tests, questionnaire surveys and scale evaluations were conducted at baseline, the end of8th,26th and52th week respectively. Physical examinations mainly included weight, height, pulse, respiratory frequency, systolic and diastolic blood pressure. Laboratory tests mainly included blood routine, urine routine, blood biochemical, electrocardiogram, urine drug and pregnancy detection. Questionnaires and scales were filled by trained social workers with face to face interviews. Questionnaires mainly included demographic dates, drug using history, drug compliance and adverse events occurred. The main scales used were self-rating anxiety scale, self-rating depression scale, addiction severity index, rating scale for protracted withdrawal symptoms, and SF-36. Visual analogue scale was used to evaluate psychological craving and pain degree. Full analysis set for clinical effectiveness analysis and compliance evaluation, and safety analysis set for safety evaluation were performed in the study. The main response variable was relapse rate, and the secondary indexes were anxiety, depression, psychological craving, pain degree, protracted withdrawal symptoms, addiction severity index, health status and adverse events. Results1. In comprehensive group, the relapse rate were2.43%,4.37%,6.31%and10.68%in the1st month,3rd month, half-year and1-year respectively, whereas in pure group, the relapse rate were0.60%,1.19%,4.76%and10.12%, respectively. There were no significant differences of relapse rates between the two groups (.P>0.05).2. There were no significant improvements in anxiety of the two groups which were higher than Chinese Norm (P<0.001) and no significant difference between groups from baseline to the end of52th week (P>0.05). The depression scores of the two groups were significantly decreased from27th week to the end of52th week and lower than Chinese Norm (P<0.001), whereas there were no significant improvements in depression of the two groups which were higher than Chinese Norm (P<0.001) from baseline to the end of26th week, and no significant differences between groups from baseline to the end of52th week (P>0.05).3. There were no significant differences of psychological craving, pain degree, protracted withdrawal symptoms and its four factors physical symptoms, emotional symptom, craving symptom and sleep disorders between groups from baseline to the end of52th week (P>0.05).4. There were no significant differences of medical, employment, alcohol, family/social and psychology between groups at baseline (P>0.05). The mean ranks of alcohol, drug, legal and family/social of pure group at the end of8th week, medical, alcohol, drug, legal and family/social at the end of26th week, medical and legal at the end of52th week of pure group were higher than comprehensive group (P<0.05).5. There were no significant differences of physical component summary, mental component summary and every dimensions of SF-36between groups from baseline to the end of52th week (P>0.05), except that mental component summary, social functioning and mental health of pure group were higher than comprehensive group at the end of8th week (P<0.01).6. The main possible adverse reactions of Jitai tablets were dizziness, dry mouth, decreased appetite, blurred vision, which were slight and mainly happened at the beginning of treatment. There was no significant difference of the incidence of possible adverse reactions between groups (P>0.05). Conclusion1. The two community drug treatments, Jitai tablets, social support and psychological intervention, Jitai tablets and social support, can decrease relapse rate effectively.2. There are no obvious effects of psychological intervention in anti-anxiety and anti-depression, decreasing psychological craving, pain degree, protracted withdrawal symptoms, addiction severity index, incidence of adverse event, and improving health status.3. There is no obvious effect of psychological intervention in relapse prevention.