Costello E J, Erkanli A, Federman E, Angold A
Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27710, USA.
J Clin Child Psychol. 1999 Sep;28(3):298-311. doi: 10.1207/S15374424jccp280302.
Examined the impact of childhood psychiatric disorders on the prevalence and timing of substance use and abuse and tested for sex differences. A representative population sample of 1,420 children, ages 9, 11, and 13 at intake, were interviewed annually. American Indians and youth with behavioral problems were oversampled; data were weighted back to population levels for analysis. By age 16, more than half the sample reported substance use, and 6% had abuse or dependence. Alcohol use began by age 9, and smoking in the 13th year. Mean onset of dependence was 14.8 years, and mean onset of abuse was 15.1 years. Substance use began earlier in boys, but not girls, who later developed abuse or dependence. Disruptive behavior disorders and depression were associated with a higher rate and earlier onset of substance use and abuse in both sexes, but anxiety predicted later onset of smoking. Family drug problems were the strongest correlate of early onset. Despite differences in prevalence of psychopathology, boys and girls showed more similarities than differences in the course of early substance use and abuse, and its associations with psychopathology.
研究了儿童期精神障碍对物质使用和滥用的患病率及发生时间的影响，并对性别差异进行了测试。对一个具有代表性的人群样本进行了研究，该样本包括1420名儿童，在初次纳入研究时年龄分别为9岁、11岁和13岁，每年进行访谈。美洲印第安人和有行为问题的青少年被过度抽样；数据经过加权处理以回到总体水平进行分析。到16岁时，超过一半的样本报告有物质使用情况，6%的人存在滥用或依赖问题。9岁开始饮酒，13岁开始吸烟。依赖的平均发病年龄为14.8岁，滥用的平均发病年龄为15.1岁。物质使用在男孩中开始得更早，但女孩并非如此，女孩后来出现滥用或依赖问题。破坏性行为障碍和抑郁症与两性中物质使用和滥用的较高发生率及更早发病有关，但焦虑预示着吸烟的发病时间较晚。家庭药物问题是早发的最强相关因素。尽管精神病理学患病率存在差异，但在早期物质使用和滥用过程及其与精神病理学的关联方面，男孩和女孩表现出的相似之处多于差异。
