Swartz Marvin S, Wagner H Ryan, Swanson Jeffrey W, Stroup T Scott, McEvoy Joseph P, Canive Jose M, Miller Del D, Reimherr Fred, McGee Mark, Khan Ahsan, Van Dorn Richard, Rosenheck Robert A, Lieberman Jeffrey A
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
J Nerv Ment Dis. 2006 Mar;194(3):164-72. doi: 10.1097/01.nmd.0000202575.79453.6e.
This study examined baseline correlates of substance use in the NIMH Clinical Antipsychotic Trials of Intervention Effectiveness project. Approximately 60% of the sample was found to use substances, including 37% with current evidence of substance use disorders. Users (with and without substance use disorders), compared with nonusers, were significantly more likely to be male, be African-American, have lower educational attainment, have a recent period of homelessness, report more childhood conduct problems, have a history of major depression, have lower negative symptom and higher positive symptom scores on the Positive and Negative Syndrome Scale, and have a recent illness exacerbation. Individuals with comorbid substance use disorders were significantly more likely to be male, report more childhood conduct problems, have higher positive symptom scores on the Positive and Negative Syndrome Scale, and have a recent illness exacerbation. These analyses suggest that substance use disorders in schizophrenia are especially common among men with a history of childhood conduct disorder problems and that childhood conduct disorder problems are potent risk factors for substance use disorders in schizophrenia.
本研究在国家心理健康研究所抗精神病药物干预有效性临床研究项目中，对物质使用的基线相关性进行了调查。约60%的样本被发现使用物质，其中37%目前有物质使用障碍的证据。与未使用者相比，使用者（无论是否有物质使用障碍）更有可能为男性、非裔美国人，教育程度较低，近期有过无家可归经历，报告更多童年期品行问题，有重度抑郁病史，在阳性与阴性症状量表上阴性症状得分较低、阳性症状得分较高，且近期病情加重。患有共病物质使用障碍的个体更有可能为男性，报告更多童年期品行问题，在阳性与阴性症状量表上阳性症状得分较高，且近期病情加重。这些分析表明，精神分裂症中的物质使用障碍在有童年期品行障碍问题病史的男性中尤为常见，且童年期品行障碍问题是精神分裂症中物质使用障碍的有力风险因素。
