Heffner Jaimee L, Anthenelli Robert M, Adler Caleb M, Strakowski Stephen M, Beavers Jennifer, DelBello Melissa P
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Psychiatry Res. 2013 Dec 30;210(3):857-62. doi: 10.1016/j.psychres.2013.04.010. Epub 2013 May 17.
The study examined the prevalence and correlates of heavy smoking and nicotine dependence in adolescents with bipolar and cannabis use disorders. Participants were 80 adolescents between 13 and 22 years of age with co-occurring bipolar I disorder and cannabis abuse or dependence who reported ever trying a cigarette. Diagnostic and symptom severity measures were completed as part of the baseline assessments for a clinical trial. Almost half (49%) of these participants who ever tried a cigarette were current heavy smokers (≥10 cigarettes/day), and 70% met DSM-IV-TR lifetime criteria for nicotine dependence. Heavy smoking was associated with older age, heavier marijuana use and greater compulsive craving, lifetime diagnoses of attention-deficit/hyperactivity disorder, conduct disorder, illicit drug use disorders, and poorer overall functioning. Nicotine dependence was related to White race, higher current mania severity, and poorer overall functioning. These findings suggest that heavy smoking and nicotine dependence were highly prevalent among these adolescents. Although both were associated with greater physical and psychosocial problems, only heavy smoking was linked to a clear pattern of more severe substance-related and psychiatric problems. Further research to elucidate mechanisms and develop interventions to address early, entrenched patterns of co-use of tobacco and marijuana is warranted.
该研究调查了患有双相情感障碍和大麻使用障碍的青少年中重度吸烟及尼古丁依赖的患病率及其相关因素。研究对象为80名年龄在13至22岁之间、同时患有双相I型障碍和大麻滥用或依赖且报告曾尝试吸烟的青少年。诊断和症状严重程度测量作为一项临床试验基线评估的一部分得以完成。这些曾尝试吸烟的参与者中，近一半（49%）为当前的重度吸烟者（每天吸≥10支烟），70%符合DSM-IV-TR尼古丁依赖的终身标准。重度吸烟与年龄较大、大麻使用量更大、更强的强迫性渴望、注意力缺陷多动障碍、品行障碍、非法药物使用障碍的终身诊断以及整体功能较差有关。尼古丁依赖与白人种族、当前更高的躁狂严重程度以及较差的整体功能有关。这些发现表明，重度吸烟和尼古丁依赖在这些青少年中非常普遍。尽管两者都与更多的身体和心理社会问题相关，但只有重度吸烟与更严重的物质相关和精神问题的明显模式有关。有必要进行进一步研究以阐明机制并制定干预措施，以解决烟草和大麻早期、根深蒂固的共同使用模式。
