Westermeyer J, Boedicker A E
Minneapolis VA Medical Center, and University of Minnesota, 55417, USA.
Am J Drug Alcohol Abuse. 2000 Nov;26(4):523-35. doi: 10.1081/ada-100101893.
To assess the course and severity of substance-related disorder (SRD) in relation to gender.
Retrospective data on course were obtained for several indices of substance use, abuse, and related morbidity.
Two university medical centers with alcohol-drug programs located in departments of psychiatry.
A total of 642 patients were assessed, of whom 365 (57%) were men and 277 (43%) were women.
Data on course included demographic characteristics, family history of substance abuse, lifetime use, age at first use, years of use, use in the last year, periods of abstinence, and current diagnosis. Data on severity included two measures of SRD-associated problems (one patient rated and one interviewer rated), substance abuse versus dependence, self-help activities, and previous treatment.
Women were more apt to be homemakers; to have a sibling or, if married, a spouse who abused substances; to be less apt to have ever used hallucinogens or inhalants; to have used substances for fewer years; to have used cannabis and inhalants for fewer days in the last year; to have a lower rate of current cannabis abuse/dependence; to have fewer legal problems related to substances (especially driving while intoxicated [DWI] charges); to have fewer outpatient admissions to treatment; to have fewer admissions to substance abuse treatment (all categories together), fewer lifetime days in treatment, and lower overall treatment cost (for all categories of treatment together).
These data confirm earlier reports of a shorter course, less deviant drug usage, and--if married--a substance-abusing spouse. In addition, we found higher rates of familial substance abuse and lower rates of lifetime admissions, treatment days, and total cost of substance abuse treatment. Homemaking responsibilities, a substance-abusing spouse, a male-oriented treatment system, and/or a more rapid course may reduce substance abuse treatment for women.
评估与性别相关的物质使用障碍（SRD）的病程及严重程度。
获取关于物质使用、滥用及相关发病率的多个指标的回顾性病程数据。
两家大学医学中心，其酒精-药物项目设在精神科。
共评估了642例患者，其中365例（57%）为男性，277例（43%）为女性。
病程数据包括人口统计学特征、物质滥用家族史、终生使用情况、首次使用年龄、使用年限、过去一年的使用情况、戒断期以及当前诊断。严重程度数据包括两种与SRD相关问题的测量指标（一个由患者评定，一个由访谈者评定）、物质滥用与物质依赖、自助活动以及既往治疗情况。
女性更倾向于成为家庭主妇；有兄弟姐妹或（已婚情况下）有滥用物质的配偶；较少曾使用致幻剂或吸入剂；使用物质的年限较短；过去一年使用大麻和吸入剂的天数较少；当前大麻滥用/依赖的发生率较低；与物质相关的法律问题较少（尤其是酒后驾车指控）；门诊治疗入院次数较少；物质滥用治疗（所有类别合计）入院次数较少、终生治疗天数较少且总体治疗费用较低（所有治疗类别的合计）。
这些数据证实了早期关于病程较短、药物使用偏差较小以及（已婚情况下）有滥用物质配偶的报道。此外，我们发现家族性物质滥用发生率较高，而终生入院率、治疗天数和物质滥用治疗总费用较低。家庭责任、有滥用物质的配偶、以男性为导向的治疗系统和/或病程较快可能会减少女性的物质滥用治疗。
