Bolton James, Cox Brian, Clara Ian, Sareen Jitender
Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
J Nerv Ment Dis. 2006 Nov;194(11):818-25. doi: 10.1097/01.nmd.0000244481.63148.98.
This study examined the prevalence and correlates of self-medication of anxiety disorders with alcohol and drugs in a nationally representative sample (N = 5877). A modified version of the Composite International Diagnostic Interview was used to make DSM-III-R mental disorder diagnoses. Frequencies of self-medication ranged from 7.9% (social phobia, speaking subtype) to 35.6% (generalized anxiety disorder). Among respondents with an anxiety disorder, self-medication was significantly associated with an increased likelihood of comorbid mood disorders, substance use disorders, distress, suicidal ideation, and suicide attempts. Self-medication behavior remained significantly associated with an increased likelihood of suicidal ideation (adjusted odds ratio = 1.66; 1.17-2.36) as well as suicide attempts (adjusted odds ratio = 2.23; 1.50-3.31), even after adjusting for a number of sociodemographic and psychiatric variables. These results suggest that individuals with anxiety disorders who self-medicate their symptoms with alcohol or drugs may be at increased risk for mood and substance use disorders and suicidal behavior.
本研究在一个具有全国代表性的样本(N = 5877)中,考察了焦虑症患者使用酒精和药物进行自我药疗的患病率及其相关因素。采用了经过修改的《复合国际诊断访谈》来做出DSM-III-R精神障碍诊断。自我药疗的频率范围从7.9%(社交恐惧症,演讲亚型)到35.6%(广泛性焦虑症)。在患有焦虑症的受访者中,自我药疗与共病情绪障碍、物质使用障碍、痛苦、自杀意念和自杀未遂的可能性增加显著相关。即使在对一些社会人口学和精神科变量进行调整之后,自我药疗行为仍与自杀意念(调整后的优势比 = 1.66;1.17 - 2.36)以及自杀未遂(调整后的优势比 = 2.23;1.50 - 3.31)的可能性增加显著相关。这些结果表明,使用酒精或药物自我治疗症状的焦虑症患者可能有更高的患情绪和物质使用障碍以及自杀行为的风险。