Centre for Brain and Mental Health Research, Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia.
Addict Behav. 2012 Apr;37(4):427-34. doi: 10.1016/j.addbeh.2011.11.039. Epub 2011 Dec 4.
Comorbidity of mental disorders and substance use continues to be a major problem. To inform the development of more effective interventions for these co-existing disorders, this paper aimed to determine if there are clear variations in the reasons for tobacco, alcohol or cannabis use across people with different mental disorders.
Data from five randomized controlled trials on co-existing disorders that measured reasons for tobacco, alcohol or cannabis use using the Drug Use Motives Questionnaire, Reasons for Smoking Questionnaire or via free response are reported and combined. Two studies involved participants with depression, two involved participants with a psychotic disorder and one involved participants with a range of mental disorders. A series of logistic regressions were conducted to examine differences in reasons for tobacco, alcohol or cannabis use and to compare these reasons between people with psychotic disorders or depression.
Participants had a mean age of 38 (SD=12) and just over half (60%) were male. Forty-six percent of participants had a psychotic disorder and 54% experienced depression. Data from 976 participants across the five studies were included in the analyses. Tobacco and alcohol were primarily used to cope, while cannabis was primarily used for pleasure. People with psychotic disorders were more likely than people with depression to use tobacco for coping, pleasure and illness motives. People with depression, in contrast, were more likely to use alcohol for these reasons and social reasons.
It may be important to tailor interventions for co-existing mental disorders and substance use by substance type and type of mental disorder. For example, interventions might be improved by including alternative coping strategies to tobacco and/or alcohol use, by addressing the social role of alcohol and by helping people with mental disorders using cannabis to gain pleasure from their lives in other ways.
精神障碍和物质使用的共病仍然是一个主要问题。为了为这些共存疾病制定更有效的干预措施，本文旨在确定患有不同精神障碍的人群中，吸烟、饮酒或使用大麻的原因是否存在明显差异。
本研究报告并综合了五项关于共存障碍的随机对照试验的数据，这些试验使用药物使用动机问卷、吸烟原因问卷或通过自由回答来衡量吸烟、饮酒或使用大麻的原因。两项研究涉及抑郁患者，两项研究涉及精神障碍患者，一项研究涉及多种精神障碍患者。进行了一系列逻辑回归分析，以检查吸烟、饮酒或使用大麻的原因差异，并比较精神障碍或抑郁患者之间的这些原因。
参与者的平均年龄为 38 岁（SD=12），超过一半（60%）为男性。46%的参与者患有精神障碍，54%的参与者患有抑郁症。五项研究共 976 名参与者的数据纳入了分析。吸烟和饮酒主要用于应对，而大麻主要用于娱乐。与患有抑郁症的人相比，患有精神障碍的人更有可能出于应对、愉悦和疾病的原因使用烟草。相比之下，患有抑郁症的人更有可能出于这些原因和社交原因饮酒。
根据物质类型和精神障碍类型，为共存精神障碍和物质使用量身定制干预措施可能很重要。例如，通过包括替代应对策略来替代吸烟和/或饮酒，解决酒精的社会角色，并帮助使用大麻的精神障碍患者以其他方式从生活中获得愉悦，干预措施可能会得到改善。
