Encrenaz Gaëlle, Kovess-Masféty Viviane, Jutand Marthe-Aline, Carmona Elodie, Sapinho David, Messiah Antoine
Institut National de la Santé et de la Recherche Médicale, Bordeaux, France.
Psychiatr Serv. 2009 Mar;60(3):351-7. doi: 10.1176/ps.2009.60.3.351.
The use of psychoactive substances in response to psychological distress is not well documented in the general population and has never been studied in combination with health care use. This study estimated the frequency of health care and substance use in response to anxiety or depressive disorders and determined factors associated with these behaviors.
From a large survey of adults from four French regions, the authors selected those with a 12-month probable anxiety or depressive disorder without a substance use disorder (N=4,071). These disorders were determined with the Composite International Diagnostic Interview Short Form, and participants were asked whether they used substances or health care in response to each disorder.
The use of substances in response to anxiety or depressive disorders was 12.9% among men and 5.2% among women. Compared with those who used health care only, those who used substances (with or without health care) were more likely to be men, single, and young. Those who used both substances and health care were also less likely to have a depressive disorder.
This study shows that a sizeable portion of the general population uses substances in response to anxiety or depressive disorders. It also shows that these substance users have distinctive sociodemographic characteristics and can thus be targeted by prevention programs. Strategies to reach substance users with depressive or anxiety disorders who do not use health care remain to be elaborated.
在普通人群中，使用精神活性物质来应对心理困扰的情况尚无充分记录，且从未与医疗保健使用情况结合起来进行研究。本研究估计了因焦虑或抑郁障碍而使用医疗保健和物质的频率，并确定了与这些行为相关的因素。
作者从对法国四个地区成年人的一项大型调查中，选取了那些患有12个月可能的焦虑或抑郁障碍但无物质使用障碍的人（N = 4071）。这些障碍通过综合国际诊断访谈简表确定，并询问参与者是否针对每种障碍使用过物质或医疗保健。
因焦虑或抑郁障碍而使用物质的情况在男性中为12.9%，在女性中为5.2%。与仅使用医疗保健的人相比，使用物质（无论是否使用医疗保健）的人更可能是男性、单身且年轻。同时使用物质和医疗保健的人患抑郁症的可能性也较小。
本研究表明，相当一部分普通人群使用物质来应对焦虑或抑郁障碍。研究还表明，这些物质使用者具有独特的社会人口学特征，因此预防项目可以针对他们。针对不使用医疗保健的抑郁或焦虑障碍物质使用者的干预策略仍有待制定。
