Latvala Antti, Tuulio-Henriksson Annamari, Perälä Jonna, Saarni Samuli I, Aalto-Setälä Terhi, Aro Hillevi, Korhonen Tellervo, Koskinen Seppo, Lönnqvist Jouko, Kaprio Jaakko, Suvisaari Jaana
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
BMC Psychiatry. 2009 Nov 19;9:73. doi: 10.1186/1471-244X-9-73.
Several risk factors for alcohol and other substance use disorders (SUDs) have been identified, but it is not well understood whether their associations with SUD are independent of each other. In particular, it is not well known, whether the associations between behavioral and affective factors and SUDs are independent of other risk factors. The incidence of SUDs peaks by young adulthood making epidemiological studies of SUDs in young adults informative.
In a comprehensive population-based survey of mental health in Finnish young adults (aged 21-35 years, n = 605), structured clinical interview (SCID-I) complemented by medical record data from all lifetime hospital and outpatient treatments were used to diagnose SUDs. We estimated the prevalences of lifetime DSM-IV SUDs, and investigated their associations with correlates from four domains representing: (1) behavioral and affective factors, (2) parental factors, (3) early initiation of substance use, and (4) educational factors. Independence of the association of behavioral and affective factors with SUD was investigated.
Lifetime prevalences of abuse or dependence of any substance, alcohol, and any illicit substance were 14.2%, 13.1%, and 4.4%, respectively. Correlates from all four domains were associated with SUD. The associations between behavioral and affective factors (attention or behavior problems at school, aggression, anxiousness) and SUD were largely independent of other correlates, whereas only daily smoking and low education associated with SUD after adjustment for behavioral and affective factors.
Alcohol use disorders are common in Finnish young adults, whereas other SUDs are less common than in many other developed countries. Our cross-sectional analyses suggested that the association between behavioral and affective factors and SUD was only partly accounted for by other correlates, such as early initiation of substance use and parental alcohol problems. In contrast, associations between many other factors and SUD were non-significant when adjusted for behavioral and affective factors.
已确定了酒精及其他物质使用障碍(SUDs)的若干风险因素,但它们与SUDs之间的关联是否相互独立尚不清楚。特别是,行为和情感因素与SUDs之间的关联是否独立于其他风险因素尚不为人所知。SUDs的发病率在青年期达到峰值,这使得对青年成年人SUDs的流行病学研究具有参考价值。
在一项针对芬兰青年成年人(年龄21 - 35岁,n = 605)的基于人群的综合心理健康调查中,采用结构化临床访谈(SCID - I)并辅以所有终身住院和门诊治疗的病历数据来诊断SUDs。我们估计了终身DSM - IV SUDs的患病率,并研究了它们与代表以下四个领域的相关因素之间的关联:(1)行为和情感因素,(2)父母因素,(3)物质使用的早期开始,以及(4)教育因素。研究了行为和情感因素与SUD关联的独立性。
任何物质、酒精和任何非法物质的滥用或依赖的终身患病率分别为14.2%、13.1%和4.4%。来自所有四个领域的相关因素均与SUD相关。行为和情感因素(在学校的注意力或行为问题、攻击性、焦虑)与SUD之间的关联在很大程度上独立于其他相关因素,而在调整行为和情感因素后,只有每日吸烟和低教育程度与SUD相关。
酒精使用障碍在芬兰青年成年人中很常见,而其他SUDs比许多其他发达国家少见。我们的横断面分析表明,行为和情感因素与SUD之间的关联仅部分由其他相关因素解释,如物质使用的早期开始和父母的酒精问题。相比之下,在调整行为和情感因素后,许多其他因素与SUD之间的关联无统计学意义。