Psychiatric and alcohol disorders as risk factors for drug abuse
Tóm tắt
This study tested the hypothesis that a history of psychiatric and alcohol disorders would affect the risk of developing drug abuse or dependence later in life. This case-control study selected cases and controls using the “snowball” technique in order to obtain cases from this “hidden” population and to match sex, age and friendship. Information was gathered using the Composite International Diagnostic Interview (CIDI), and computer diagnoses were generated according to the DSM-III-R criteria. The study included 370 subjects. Results of the conditional logistic regression analysis showed that having a history of alcohol dependence was independently associated with an increased risk of drug abuse/dependence (OR=2.6, 95% CI 1.1–6.0) and that this risk was even higher for those whose alcohol dependence occurred in combination with another psychiatric disorder (OR=4.6, 95% CI 2.1–10.0). An increased risk of drug abuse/dependence was also found for those who were aged 12 years or under when their first psychiatric disorder was manifested (OR=2.2, 95% CI 1.3–3.7) and among those with two or more psychiatric disorders (OR=2.5, 95% CI 1.5–4.1). These findings suggest that programmes directed towards the treatment and prevention of drug abuse must be prepared to address psychiatric and alcohol disorders in childhood and adolescence.
Tài liệu tham khảo
American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn, revised (DSM-III-R). American Psychiatric Association Washington, DC
Avico U, Kaplan C, Korczak D, Van Meter K (1988) Cocaine epidemiology in three European community cities: a pilot study using a snowball sampling methodology. In Research Report of the Cocaine Steering Group, Health Directorate Commission of the European Community Brussels, Belgium
Berkson J (1946) Limitations on the application of the four-fold table analysis to hospital data. Biometrics 2:47–53
Biernacki P, Waldford D (1981) Showball sampling: problems and techniques of chain refenal sampling. Sociol Methods Res 2:141–163
Boyle MH, Offord DR (1991) Psychiatric disorder and substance use in adolescence. Can J Psychiatry 36:699–705
Boyle MH, Offord DR, Racine YA, Szatmari P, Fleming JE, Links PS (1992) Predicting substance use in late adolescence: results from the Ontario Child Health Study follow-up. Am J Psychiatry 149:761–767
Braucht GN, Brakarsch D, Follingstad D, Berry KL (1973) Deviant drug use in adolescence: a review of psychological correlates. Psychol Bull 79:92–106
Breslow NE, Day NE (1980) Statistical methods in cancer research, vol 1-The analysis of case-control studies. International Agency for Research on Cancer (IARC Scientific Publications No. 32), Lyon
Carroll KM, Rounsaville BJ (1992) Contrast of treatment-seeking and untreated cocaine abusers. Arch Gen Psychiatry 49:464–471
Christie KA, Burke JDJ, Regier DA, Rae JH, Locke BZ (1988) Epidemiologic evidence for early onset of mental disorders and higher risk of drug abuse in young adults. Am J Psychiatry 145:971–975
Clayton D, Hills M (1993) Statistical models in epidemiology. Oxford University Press, Oxford
Deykin EY, Levy JC, Wells V (1987) Adolescent depression, alcohol and drug abuse. Am J Public Health 77:178–182
Flanders WD, Austin H (1986) Possibility of selection bias in matched case-control studies using friend controls. Am J Epidemiol 124:150–153
Goodman L (1961) Snowball sampling. Ann Math Stat 32:245–268
Green J, Weiss RD, Mirin SM, Wilson H, Bouchard-Voelk B (1987) The use of the diagnostic interview schedule in drug-dependent patients. Am J Drug Alcohol Abuse 13:281–291
Griffiths P, Gossop M, Powis B, Strang J (1993) Reaching hidden populations of drug abusers by privileged access interviewers: methodological and practice issues. Addiction 88:1617–1626
Hasin DS, Grant BF (1987) Psychiatric diagnosis of patients with substance abuse problems: a comparison of two procedures, the DIS and the SADS-L. J Physchiatr Res 21:7–22
Helzer JE, Pryzbeck TR (1938) The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment. J Stud Alcohol 49:219–224
Hendriks VM (1990) Psychiatric disorders in a Dutch addict population: rates and correlates of DSM-III diagnosis. J Consult Clin Psychol 58:158–165
Hennekens CH, Buring JE (1987) Epidemiology in medicine. Little, Brown and Company, Boston
Hosmer DW, Lemeshow S (1989) Applied logistic regression. Wiley, New York
Kandel DB, Logan JA (1984) Patterns of drug use from adolescence to young adulthood: I. Periods of risk for initiation, continued use, and discontinuation. Am J Public Health 74:660–666
Kandel DB, Yamaguchi K, Chen K (1992) Stages of progression in drug involvement from adolescence to adulthood: further evidence for the Gateway theory. J Stud Alcohol 53:447–457
Kaplan CD, Korf D, Sterk C (1987) Temporal and social conterxts of heroin-using populations: an illustration of the snowball sampling technique. J Nerv Ment Dis 175:566–574
Kleinbaum DG, Kupper LL, Morgenstern H (1982) Epidemiologic research. Principles and quantitative methods. Van Nostrand Reinhold, New York
Kleimnan PH, Miller AB, Millman RB, Woody GE, Todd T, Kemp J, Lipton DS (1990) Psychopathology among cocaine abusers entering treatment. J Nery Ment Dis 178:442–447
Lewis G Williams P (1989) Clinical judgement and the standardised interview in psychiatry. Psychol Med 19:971–980
Lopes CS (1994a) Psychiatric risk factors for drug abuse among adults in Rio de Janeiro. PhD Thesis, Institute of Psychiatry, University of London, Rio de Janeiro
Lopes CS (1994b) Reliability of the Brazilian version of the CIDI in a case-control study of risk factors for drug abuse among adults in Rio de Janeiro. Bull PAHO 28:34–41
Lopes CS, Mari JJ, Szwarcwald CL (1991) Morbidade psiquiatrica em pacientes usuarios de drogas. Rev ABP APAL 13:161–169
McAree CP, Steffenhagen RA, Zhentlen LS (1972) Personality factors and patterns of drug usage in college students. Am J Psychiatry 128:890–893
Meter KM (1990) Methodological and design issues: techniques for assessing the representatives of snowball samples. In: Lambert E (ed) The collection and interpretation of data from hidden populations. NIDA Research Monograph 98, Rockville, pp 31–43
Miller NS, Ries RK (1991) Drug and alcohol dependence and psychiatric populations: the need for diagnosis, intervention, and training. Compr Psychiatry 32:268–276
Morgado AF (1983) Dependencia de drogas: descricao de uma pesquisa empirica e revisao de alguns aspectos relevantes para sua prevencao. PhD Thesis. Universidade de Sao Paulo, Sao Paulo
Newcomb MD, Maddahian E, Bentler PM (1986) Risk factors for drug use among adolescents: concurrent and longitudinal analyses. Am J Public Health 76:525–531
Paton S, Kessler R, Kandel D (1977) Depressive mood and adolescent illicit drug use: a longitudinal analysis. J Gen Psychol 131:267–289
Pike M, Robins J (1989) Re: “Possibility of selection bias in matched case-control studies using friend controls” (letter). Am J Epidemiol 130:209–210
Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ (1990) Comorbidity of mental disorders with alcohol and other drug abuse Results from the epidemiologic catchment area (ECA) study JAMA 264:2511–2518
Robins LN, Przybeck TR (1985) Age of onset of drug use as a factor in drug and other disorders. In: Jones CLR, Battjes RJ (eds) Etiology of drug abuse: implications for prevention. National Institute on Drug Abuse, Research Monograph 56, Rockville, Md, pp 178–192
Robins LN, Wing J, Wittchen HU, Helzer JE, Babor TF, Burke JD, Farmer A, Jablenski A, Pickens R, Regier DA, Sartorius N, Towle L (1988) The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 45:1069–1077
Rodrigues LC (1986) A case control study of measles vaccine efficacy. PhD Thesis. University of London, London
Ross HE, Glazer FB, Germanson T (1988) The prevalence of psychiatric disorders in patients with alcohol and other drug problems. Arch Gen Psychiatry 45:1023–1031
Rounsaville BJ, Kleber H (1985) Untreated opiate addicts. How do they differ from those seeking treatment? Arch Gen Psychiatry 42:1072–1077
Rounsaville BJ, Weissman MM, Kleber H (1982) Heterogeneity of psychiatric diagnosis in treated opiate addicts. Arch Gen Psychiatry 39:161–166
Rounsaville BJ, Anton SF, Carroll K, Budde D, Prusoff BA, Gawin F (1991) Psychiatric diagnosis of treatment-seeking cocaine abusers. Arch Gen Psychiatry 48:43–51
Stowell RJ, Estroff TW (1992) Psychiatric disorders in substanceabusing adolescent inpatients: a pilot study. J Am Acad Child Adolesc Psychiatry 31:1036–1040
Swady H (1992) Relative risk factors in detecting adolescent drug abuse. Drug Alcohol Depend 29:253–254
Vener AM, Stewart CS, Hager DL (1972) Depression and the adolescent in middle America. Paper presented at the 67th annual meeting of the American Sociological Association in New Orleans, La. (Unpublished)
Wacholder S, McLaughlin JK, Silverman DT, Mandel JS (1992) Selection of controls in case-control studies. I. Principles. Am J Epidemiol 135:1019–1027
Yamaguchi K, Kandel DB (1984a) Patterns of drug use from adolescence to young adulthood: II. Sequences of progression. Am J Public Health 74:668–672
Yamaguchi K, Kandel DB (1984b) Patterns of drug use from adolescence to young adulthood: III. Predictors of progression. Am J Public Health 74:673–681