依存症研究と治療ジャーナル

抽象的な

Psychosocial Factors Associated with Substance-Related Disorders; Three Stratified Dimensions

Kouichi Yoshimasu

There are three major dimensional aspects with regard to associations between substance-related disorders (SRD) and psychosocial factors. They are religious/spiritual, job-related, and symptomatic (clinical) factors, each of which strongly affects or modifies the quality of life among SRD patients. Those factors construct a stratum in which each factor correlates with the other. The most fundamental factors are religious/spiritual, and based on their sense of value and morality, legal regulations on relevant substances are enforced. Such legal regulations directly stipulate job environments, in other words, social restriction as the second dimension of psychosocial factors among SRD patients. That is, illicit drug use results in dismissals and difficulty in obtaining new jobs. Since unemployment status is strongly associated with SRD, a vicious cycle is formed between SRD and unemployment. Catastrophic events such as suicide often occur as a result of such negative spiral. Due to these social factors related to substances, somatic symptoms, the final signs directly connected to medical treatments and revealed by SRD patients, might be seriously biased. Such somatic symptoms can be regarded as the third dimension of psychosocial factors surrounding SRD. Negative emotions such as stigmas, prejudices, or feelings of shame concerning one’s mental disorder (including SRD) might prevent patients from showing apparent mental symptoms associated with SRD. Because negative emotions possibly arise on the basis of cultural backgrounds, it is important to take into account the effects of such factors when evaluating and studying the associations between somatic symptoms and SRD. The most important issue for the rectification of health inequality among SRD patients is to sweep away discriminations and prejudices against SRD, but this is difficult since such negative emotions are likely to take root in a religious/spiritual context.