Brook David W, Brook Judith S, Zhang Chenshu, Cohen Patricia, Whiteman Martin
Department of Community and Preventive Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029-6574, USA.
Arch Gen Psychiatry. 2002 Nov;59(11):1039-44. doi: 10.1001/archpsyc.59.11.1039.
The Children in the Community Study is a prospective longitudinal study investigating the association between early drug use (childhood, adolescence, and early 20s) and later psychiatric disorders (in the late 20s).
Using data from a community-based sample of 736 adults (50% female) from upstate New York, the subjects were interviewed at the mean ages of 14, 16, 22, and 27 years. Psychiatric disorders, measured by age-appropriate versions of the University of Michigan Composite International Diagnostic Interview, and participant's drug use were assessed.
Adolescent and young adult tobacco use was significantly associated with an increased risk of alcohol dependence and substance use disorders at a mean age of 27 years, but not with new episodes of major depressive disorder. Earlier alcohol use significantly predicted later major depressive disorder, alcohol dependence, and substance use disorders in the late 20s, as did early marijuana use and other illicit drug use. Except for the effect of tobacco use on major depressive disorder, early drug use was significantly related to later psychiatric disorders, even after statistically controlling for age, sex, parental educational level, family income, and prior episodes of major depressive disorder and substance use disorders.
Our results suggest that early drug use is associated with and predicts later psychiatric disorders. Preventive implications stem from the importance of studying a range of psychiatric disorders in the context of substance use assessed over a wide age range.
社区儿童研究是一项前瞻性纵向研究,旨在调查早期药物使用(儿童期、青少年期和20岁出头)与后期精神障碍(20多岁后期)之间的关联。
利用来自纽约州北部736名成年人(50%为女性)的社区样本数据,在平均年龄14岁、16岁、22岁和27岁时对受试者进行访谈。通过密歇根大学综合国际诊断访谈的适用于相应年龄版本来测量精神障碍,并评估参与者的药物使用情况。
青少年和青年期吸烟与27岁时酒精依赖和物质使用障碍风险增加显著相关,但与重度抑郁症新发病例无关。早期饮酒显著预测了20多岁后期的重度抑郁症、酒精依赖和物质使用障碍,早期使用大麻和其他非法药物也有同样的作用。除了吸烟对重度抑郁症的影响外,即使在对年龄、性别、父母教育水平、家庭收入以及重度抑郁症和物质使用障碍既往发作情况进行统计学控制之后,早期药物使用仍与后期精神障碍显著相关。
我们的结果表明,早期药物使用与后期精神障碍相关且可预测后期精神障碍。预防意义源于在广泛年龄范围内评估物质使用的背景下研究一系列精神障碍的重要性。