Howard Matthew O, Perron Brian E
University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building, Campus Box 3550, 325 Pittsboro Street, Chapel Hill, NC 27599-3550, USA.
BMC Psychiatry. 2009 Mar 8;9:8. doi: 10.1186/1471-244X-9-8.
Inhalant use is among the most pernicious and poorly understood forms of adolescent substance use. Many youth in the juvenile justice system have used inhalants, but little is known about inhalant use disorders (IUDs) in antisocial youth populations. The purpose of this study was to examine the prevalence, clinical features, and latent structure of DSM-IV IUDs in a state population of antisocial youth.
Cross-sectional survey conducted in 2003. Of 740 youth residing in Missouri State Division of Youth Services' (MDYS) residential treatment facilities at the time the study was conducted, 723 (97.7%) completed interviews. Eighty-seven percent were male, with a mean age of 15.5 (SD = 1.2). Nearly 4 in 10 youth (38.5%; n = 279) reported lifetime inhalant use. Youth ranged from very mildly to severely antisocial.
Of 279 inhalant users, 52 (18.6%) met DSM-IV inhalant abuse criteria and 79 (28.3%) met inhalant dependence criteria. Five of 10 IUD criteria were met by > 10% of the total sample. Latent class analyses demonstrated a substantial concordance between DSM-IV-defined IUDs and an empirically-derived classification based on responses to DSM-IV IUD diagnostic criteria.
IUDs and constituent criteria were prevalent among youth in the juvenile justice system. Two groups of problem inhalant users were identified, symptomatic users-DSM-IV inhalant abuse and highly symptomatic users-DSM-IV inhalant dependence, which differed primarily in severity of inhalant-related problems. Inhalant screening, prevention and treatment efforts in juvenile justice settings are rarely delivered, but critically needed.
吸入剂的使用是青少年物质使用中最有害且最不为人所了解的形式之一。许多青少年司法系统中的年轻人使用过吸入剂，但对于反社会青年群体中的吸入剂使用障碍（IUDs）却知之甚少。本研究的目的是调查反社会青年群体中《精神疾病诊断与统计手册》第四版（DSM-IV）定义的吸入剂使用障碍的患病率、临床特征和潜在结构。
于2003年进行横断面调查。在研究开展时，居住在密苏里州青年服务部（MDYS）寄宿治疗机构的740名青年中，有723名（97.7%）完成了访谈。87%为男性，平均年龄15.5岁（标准差 = 1.2）。近十分之四的青年（38.5%；n = 279）报告有终生吸入剂使用史。这些青年的反社会程度从非常轻微到严重不等。
在279名吸入剂使用者中，52名（18.6%）符合DSM-IV吸入剂滥用标准，79名（28.3%）符合吸入剂依赖标准。10项吸入剂使用障碍标准中有5项被超过10%的总样本满足。潜在类别分析表明，DSM-IV定义的吸入剂使用障碍与基于对DSM-IV吸入剂使用障碍诊断标准的回答得出的经验性分类之间存在高度一致性。
吸入剂使用障碍及其构成标准在青少年司法系统的青年中很普遍。识别出了两组有问题的吸入剂使用者，有症状使用者——DSM-IV吸入剂滥用者和高度有症状使用者——DSM-IV吸入剂依赖者，二者主要在与吸入剂相关问题的严重程度上有所不同。青少年司法环境中的吸入剂筛查、预防和治疗工作很少开展，但却极为必要。
