Fischer Mariellen, Barkley Russell A
Department of Neuropsychology, Medical College of Wisconsin, Milwaukee 53226, USA.
J Clin Psychiatry. 2003;64 Suppl 11:19-23.
Conflicting studies of the relationship between therapeutic use of psychostimulant medication and substance abuse have long been a subject of concern among clinicians and researchers. One controlled longitudinal study examined this relationship in 147 patients who were diagnosed with hyperactivity as young children and were surveyed with regard to their substance use both as adolescents and as adults. This study found that stimulant therapy for attention-deficit/hyperactivity disorder in childhood is not associated with increased risk of adolescent experimentation with substance use, frequency of such use, or the risk of developing psychoactive substance use disorders by young adulthood. Moreover, stimulant therapy in high school may well have provided a protective effect against hallucinogen abuse by adulthood. A possible explanation for contradictory findings previously published was suggested by the existence of a number of potentially confounding variables, particularly conduct disorders, for which prior studies have failed to control.
关于精神兴奋药物的治疗性使用与药物滥用之间的关系,相互矛盾的研究长期以来一直是临床医生和研究人员关注的问题。一项对照纵向研究在147名幼时被诊断为多动症的患者中考察了这种关系,并对他们在青少年期和成年期的药物使用情况进行了调查。该研究发现,儿童期用于治疗注意力缺陷/多动障碍的兴奋剂疗法与青少年尝试使用药物的风险增加、此类使用的频率或到青年期发展为精神活性物质使用障碍的风险无关。此外,高中阶段的兴奋剂疗法很可能对成年期滥用致幻剂起到了预防作用。先前发表的相互矛盾的研究结果可能的解释是,存在一些潜在的混杂变量,尤其是品行障碍,而之前的研究未能对其进行控制。