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首页> 外文期刊>Journal of substance abuse treatment >Substance use outcomes in cocaine-dependent tobacco smokers: A mediation analysis exploring the role of sleep disturbance, craving, anxiety, and depression
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Substance use outcomes in cocaine-dependent tobacco smokers: A mediation analysis exploring the role of sleep disturbance, craving, anxiety, and depression

机译：可卡因依赖烟草吸烟者中的物质使用结果：探索睡眠干扰，渴望，焦虑和抑郁作用的中介分析

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BackgroundSleep disturbance may play a role in cocaine use outcomes and, hence, may be a potential therapeutic target for cocaine use disorder (CUD). Research in this area, which has largely relied on resource-intensive polysomnography, would be facilitated by identifying a self-report sleep measure predictive of CUD outcomes and by a better understanding of the mechanisms by which sleep may impact CUD outcomes. This study tested the predictive validity of the Pittsburgh Sleep Quality Index (PSQI), a self-report assessment of past-month sleep quality. To better understand potential mechanisms, mediation models relating sleep disturbance to CUD outcomes were evaluated. MethodsThis is a secondary analysis of data from cocaine-dependent (n?=?290) participants in a multi-site trial evaluating smoking-cessation treatment for stimulant-dependent patients. The PSQI was collected at baseline; the outcomes of interest were cocaine and drug abstinence at end-of-treatment (weeks 9–10). Potential mediators, measured in weeks 1–8, were: cocaine craving (Brief Substance Craving Scale); and anxiety and depression symptoms (Hospital Anxiety and Depression Scale). Mediation techniques were used to evaluate mediation effects separately and jointly. ResultsThe majority of participants (58.3%) had baseline sleep disturbance. Sleep disturbance was not a significant predictor of end-of-treatment abstinence when regressed without consideration of mediators. Cocaine craving, anxiety, and depression were significant mediators, both separately and jointly, of an effect of baseline sleep disturbance on end-of-treatment abstinence. ConclusionThis exploratory analysis suggests that there may be an indirect relationship between self-reported sleep quality and substance use outcomes in cocaine-dependent patients, mediated by craving, anxiety, and depression.Trial registration:ClinicalTrials.gov:NCT01077024.
机译：Backgroundsleep扰动可能在可卡因使用结果中发挥作用，因此，可以是可卡因使用障碍（CUD）的潜在治疗靶标。通过识别CUD成果的自我报告睡眠措施，并通过更好地理解睡眠可能影响CUD结果的机制，通过识别自我报告的睡眠措施，这是在很大依赖于资源密集型多面体摄影的领域。本研究检测了匹兹堡睡眠质量指数（PSQI）的预测有效性，自我报告的过去月睡眠质量评估。为了更好地了解潜在机制，评估了对CUD结果相关的调解模型。方法是从可卡因依赖性（N？= 290）参与者中的数据的次要分析，从而评估兴奋剂依赖患者的烟熏治疗。 PSQI在基线收集;感兴趣的结果是可卡因和治疗结束（第9-10周）的药物禁欲。在第1-8周内测量的潜在调解员是：可卡因渴望（简短的物质渴望规模）;和焦虑和抑郁症状（医院焦虑和抑郁症）。使用中介技术分别和共同评估中介效果。结果是大多数参与者（58.3％）有基线睡眠障碍。睡眠障碍不是在没有考虑调解员的情况下回归后治疗结束禁欲的重要预测因子。可卡因渴望，焦虑和抑郁是分别和共同的重要介质，对基线睡眠干扰对治疗结束禁欲的影响。结论本次探索性分析表明，通过渴望，焦虑和抑郁症介导的可卡因依赖性患者的自我报告的睡眠质量和物质使用结果之间可能存在间接关系.TRIAL注册：CLINCOLTRIANS.GOV：NCT01077024。

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