Abstract：
OBJECTIVE: Despite high rates of relapse after treatment for drug use, to our knowledge there is no systematic literature identifying psychological factors that predict risk of relapse to drug use (excluding alcohol or tobacco). Our aim was to identify psychological factors that predict risk of relapse to drug use after enrollment in drug use treatment. The identification of such factors can support treatment planning and relapse prevention.
METHODS: We searched for peer-reviewed articles published between 2000 and 2023 in PsycINFO, PsycArticles, Web of Science, and PubMed. The inclusion criteria were: peer-reviewed publications, quantitative studies, in English, adult samples, with a prospective design, and analyses of minimum one psychological factor as predictor of relapse to drug use. All authors were involved in abstract and full-text screening, and in assessing risk of bias. The findings are presented in a narrative synthesis and tables are organized by type of drug.
RESULTS: Of 2226 publications initially identified, 45 were eligible. Twenty-three focused on predicting relapse to stimulants, 15 to opioids, and 7 to unspecified drugs. Substance use at baseline was an important factor predicting risk of relapse to opioids, and possibly stimulants. There was an indication that craving and attention problems potentially predict relapse to use of some drugs. Mental health factors (e.g., psychiatric diagnosis) did not predict relapse. Several psychological factors (e.g., cognition, emotion, personality, motivation) were scarcely examined. Over half of the studies had moderate to high risk of bias.
CONCLUSIONS: Based on the 45 studies, few psychological factors predicted risk of relapse to drug use. Higher comparability between studies and more rigorous methodology are necessary in order to derive more precise recommendations that inform and improve clinical practice.
UNASSIGNED: PROSPERO, CRD42020182839.
METHODS: We searched for peer-reviewed articles published between 2000 and 2023 in PsycINFO, PsycArticles, Web of Science, and PubMed. The inclusion criteria were: peer-reviewed publications, quantitative studies, in English, adult samples, with a prospective design, and analyses of minimum one psychological factor as predictor of relapse to drug use. All authors were involved in abstract and full-text screening, and in assessing risk of bias. The findings are presented in a narrative synthesis and tables are organized by type of drug.
RESULTS: Of 2226 publications initially identified, 45 were eligible. Twenty-three focused on predicting relapse to stimulants, 15 to opioids, and 7 to unspecified drugs. Substance use at baseline was an important factor predicting risk of relapse to opioids, and possibly stimulants. There was an indication that craving and attention problems potentially predict relapse to use of some drugs. Mental health factors (e.g., psychiatric diagnosis) did not predict relapse. Several psychological factors (e.g., cognition, emotion, personality, motivation) were scarcely examined. Over half of the studies had moderate to high risk of bias.
CONCLUSIONS: Based on the 45 studies, few psychological factors predicted risk of relapse to drug use. Higher comparability between studies and more rigorous methodology are necessary in order to derive more precise recommendations that inform and improve clinical practice.
UNASSIGNED: PROSPERO, CRD42020182839.
摘要：
目的：尽管药物治疗后复发率高，据我们所知,目前还没有系统的文献确定可预测药物复发风险的心理因素(不包括酒精或烟草).我们的目的是确定预测药物使用治疗后复发风险的心理因素。这些因素的识别可以支持治疗计划和复发预防。
方法：我们搜索了2000年至2023年在PsycINFO上发表的同行评审文章，Psycarticles,WebofScience,和PubMed。纳入标准是：同行评审的出版物，定量研究，在英语中,成人样本,有了前瞻性的设计，并分析了最少一种心理因素作为药物复发的预测因素。所有作者都参与了摘要和全文筛选，以及评估偏见风险。研究结果以叙事综合形式呈现，表格按药物类型组织。
结果：在最初确定的2226种出版物中，45人符合条件。23人专注于预测兴奋剂复发，15到阿片类药物，7和未指明的药物。基线时的物质使用是预测阿片类药物复发风险的重要因素，可能还有兴奋剂。有迹象表明，渴望和注意力问题可能会预测某些药物的复发。心理健康因素(例如，精神病诊断）不能预测复发。几个心理因素(例如，认知，情感，个性,动机)几乎没有被检查过。超过一半的研究有中度到高度的偏倚风险。
结论：根据45项研究，很少有心理因素预测药物复发的风险。研究和更严格的方法之间的更高可比性是必要的，以便得出更精确的建议，为临床实践提供信息和改进。
■PROSPERO，CRD42020182839。
方法：我们搜索了2000年至2023年在PsycINFO上发表的同行评审文章，Psycarticles,WebofScience,和PubMed。纳入标准是：同行评审的出版物，定量研究，在英语中,成人样本,有了前瞻性的设计，并分析了最少一种心理因素作为药物复发的预测因素。所有作者都参与了摘要和全文筛选，以及评估偏见风险。研究结果以叙事综合形式呈现，表格按药物类型组织。
结果：在最初确定的2226种出版物中，45人符合条件。23人专注于预测兴奋剂复发，15到阿片类药物，7和未指明的药物。基线时的物质使用是预测阿片类药物复发风险的重要因素，可能还有兴奋剂。有迹象表明，渴望和注意力问题可能会预测某些药物的复发。心理健康因素(例如，精神病诊断）不能预测复发。几个心理因素(例如，认知，情感，个性,动机)几乎没有被检查过。超过一半的研究有中度到高度的偏倚风险。
结论：根据45项研究，很少有心理因素预测药物复发的风险。研究和更严格的方法之间的更高可比性是必要的，以便得出更精确的建议，为临床实践提供信息和改进。
■PROSPERO，CRD42020182839。
