Tien A Y, Anthony J C
Department of Mental Hygiene, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland 21205.
J Nerv Ment Dis. 1990 Aug;178(8):473-80.
Clinical and laboratory studies link alcohol and other drug use to the occurrence of psychotic experiences, but epidemiologic evidence has been lacking. In this study, the quantitative relationships between alcohol or other drug use and psychotic experiences were examined by analysis of prospective data from 4994 adult household residents sampled in a multisite survey of mental disorders in the population, the NIMH Epidemiologic Catchment Area Program. After control for sociodemographic factors and preexisting psychiatric conditions, the risk for onset of self-reported delusions or hallucinations was observed to be greater for daily users of marijuana or cocaine and for users of anxiolytics or sympathomimetics compared with nonusers. After control for daily cocaine use and alcohol disorder, the risk of onset of psychotic experiences for daily users of marijuana was double that for nonusers. Alcohol disorder in men was associated with eightfold risk and in women with threefold risk. Baseline depressive episodes, manic episodes, agoraphobia, and obsessive-compulsive disorder also were associated with increased risk of onset of psychotic experiences.
临床和实验室研究表明，酒精及其他药物的使用与精神病体验的发生有关，但一直缺乏流行病学证据。在本研究中，通过对4994名成年家庭居民的前瞻性数据进行分析，探讨了酒精或其他药物使用与精神病体验之间的定量关系。这些数据来自一项针对人群精神障碍的多地点调查——美国国立精神卫生研究所流行病学集水区项目。在控制了社会人口学因素和既往精神疾病状况后，发现与不使用者相比，每日使用大麻或可卡因的人以及使用抗焦虑药或拟交感神经药的人出现自我报告的妄想或幻觉的风险更高。在控制了每日可卡因使用和酒精障碍后，每日使用大麻的人出现精神病体验的风险是非使用者的两倍。男性酒精障碍与八倍的风险相关，女性与三倍的风险相关。基线时的抑郁发作、躁狂发作、广场恐惧症和强迫症也与精神病体验发作风险增加有关。
