Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari of Barcelona, Biomedical Research Center in Mental Health Network CIBERSAM, C/Villarroel, 170, 08036, Barcelona, Spain.
Eur Child Adolesc Psychiatry. 2011 Jun;20(6):279-89. doi: 10.1007/s00787-011-0173-5. Epub 2011 Apr 21.
This study aimed to describe patterns of substance use in adolescents initiating mental health treatment and analyse factors associated with a high-risk pattern of substance use differentially by gender. Two hundred and thirty-seven 12- to 17-year-old new patients in an urban public mental health service were prospectively recruited and evaluated using semi-structured interviews and standardized questionnaires to obtain socio-demographic, psychopathological, family, school and substance use data. The most prevalent primary diagnoses among males were attention deficit disorder and conduct disorder, while among females they were eating disorders, affective and conduct disorders. Substance use disorder was diagnosed as follows: cannabis in 10.1% of the sample, alcohol in 3.4% and other drugs in 0.4%. A pattern of substance use with high risk of developing problems (at least regular use of alcohol or occasional use of cannabis or other illegal drugs) was found in 48.9% of the sample. After adjusting for age in the multivariate logistic regression, this pattern of risky use of drugs was found to be associated with Youth Self-Report scales of thought problems, delinquent and aggressive behaviour, in both genders. Altered family structure, having had to repeat a school grade and Youth Self-Report attention problems were only significantly associated with risky drug consumption in females. The high prevalence of risky and problematic substance use in adolescents entering mental health treatment warrants early systematic screening and specific preventive and therapeutic interventions, addressing mental health psychoeducation and motivation to avoid drugs, as well as differential associated risk factors for males and females.
本研究旨在描述开始接受心理健康治疗的青少年的物质使用模式，并分析与高风险物质使用模式相关的因素，同时按性别进行差异分析。在城市公共心理健康服务中，前瞻性地招募了 237 名 12 至 17 岁的新患者，并使用半结构化访谈和标准化问卷对其进行评估，以获取社会人口统计学、精神病理学、家庭、学校和物质使用数据。男性最常见的主要诊断是注意缺陷障碍和品行障碍，而女性则是饮食障碍、情感和品行障碍。物质使用障碍的诊断如下：大麻在样本中的占 10.1%，酒精占 3.4%，其他药物占 0.4%。在样本中发现有 48.9%存在具有发展问题高风险的物质使用模式（至少经常使用酒精或偶尔使用大麻或其他非法药物）。在多元逻辑回归中调整年龄后，发现这种危险药物使用模式与青少年自我报告的思维问题、犯罪和攻击行为量表在两性中均相关。家庭结构改变、留级和青少年自我报告的注意力问题仅与女性的危险药物消费显著相关。进入心理健康治疗的青少年中高风险和问题性物质使用的高发率需要进行早期系统筛查和特定的预防和治疗干预，解决心理健康的心理教育和避免药物的动机问题，以及针对男性和女性的不同相关风险因素。
