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Factors Influencing Health-related Quality of Life in Alcoholics and Stimulant Abusers

出版	University of California, San Diego and San Diego State University, 1997
URL	http://books.google.com.hk/books?id=jJZd9slbV3IC&hl=&source=gbs_api

註釋Alcoholism and drug abuse are associated with neuropsychological impairment, medical morbidity, and mood disturbance, though little is known how these factors impact health-related quality of life in alcoholics and stimulant abusers. This study assessed health-related quality of life, as measured by the Quality of Well-Being Scale, in alcohol and stimulant abusers with varying degrees of abstinence, and determined the relative contributions of neuropsychological impairment, medical status and mood disturbance. It was predicted that recent abstinence (30 days) would be associated with lower health-related quality of life; prolonged abstinence (greater than 18 months), correlated with improved physical and psychological states, would be associated with normalization of health-related quality of life. The study consisted of two parts. Part I included 41 recently detoxified alcohol/stimulant abusers (RDA; mean age = 42.9; SD = 10.9), and 50 long-term abstinent alcohol/stimulant abusers (LTA; age = 57.3; SD = 8.7), who met criteria for alcohol dependence, and for a subset, alcohol and stimulant dependence. Results indicated that RDAs and LTAs had lower QWB scores than a group of nonalcoholic controls (NAC). Using age as a covariate, the RDA group was significantly more impaired on a set of neuropsychological tests than the NAC group, while the LTA group was indistinguishable from the NAC group. RDA and LTA groups endorsed higher levels of medical morbidity and mood disturbance than the NAC group. Multiple regression analyses revealed mood and medical morbidity significantly lowered QWB scores in the alcoholic groups. Path analysis using a theoretical model predicting QWB score from contributions of age and education, abstinence duration, neuropsychological functioning, medical status, and mood revealed mood and medical status to be the only salient contributors. Part II assessed QWB score change at a 6-month follow-up in a subset of the RDA group (n = 17). Relapse was associated with a significant decrease in QWB score relative to abstainers. It appears alcohol/stimulant abuse impacts health-related quality of life, and the impairment may not fully recover in alcohol/stimulant abusers despite prolonged abstinence and apparent normalization of neuropsychological functioning. Residual subclinical medical and mood disturbance may account in part for reduction in life quality.