Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Researcher, Douglas Mental Health University Institute, Montreal, Quebec; Scientific Director, Montreal Addiction Rehabilitation Centre-University Institute, Montreal, Quebec.
Research Associate, Douglas Mental Health University Institute, Montreal, Quebec.
Can J Psychiatry. 2014 Apr;59(4):203-12. doi: 10.1177/070674371405900405.
Our study sought to identify sociodemographic, clinical, life perception, and service use characteristics that distinguish new cases of people dependent on substances from the general population; and to determine predictors of substance dependence over a 2-year period. Variables that differentiate people dependent on substances according to sex and age were also assessed.
Among 2434 people who took part in an epidemiologic catchment area health survey at baseline, 2.2% were identified with substance dependence at the second measurement time only. Using a comprehensive framework, various aspects were considered as predictors for multivariate statistics.
Participants with substance dependence at time 2 only showed worse clinical conditions, life events, life and health perception, and neighbourhood characteristics than other participants, but only 2.5% used health care services. Male sex, younger age, stigmatization, and impulsiveness were predictors of substance dependence. Regarding sex, females with dependence were only more likely to suffer from social phobia than males. In terms of age categories, participants over 50 with substance dependence were more likely to have a lower household income and less social support than younger people.
Stigmatization was the strongest predictor of substance dependence. Our study also confirmed that males and younger people were more likely to have substance dependence. Anti-stigmatization, prevention, and outreach programs are needed to overcome the reluctance of this clientele to use health care services. Health professionals should also pay more attention to life and health perception and neighbourhood characteristics of newly identified drug users.
本研究旨在确定物质依赖新发病例与一般人群在社会人口学、临床、生活感知和服务利用方面的特征，并确定在 2 年内物质依赖的预测因素。还评估了根据性别和年龄区分物质依赖者的变量。
在基线时参加了一项流行病学抽样区健康调查的 2434 人中，只有 2.2%在第二次测量时被确定为物质依赖。使用综合框架，将各个方面作为多元统计的预测因素进行考虑。
仅在时间 2 时具有物质依赖的参与者表现出比其他参与者更差的临床状况、生活事件、生活和健康感知以及邻里特征，但只有 2.5%使用了医疗保健服务。男性、年龄较小、污名化和冲动是物质依赖的预测因素。就性别而言，依赖的女性比男性更容易患社交恐惧症。就年龄类别而言，50 岁以上有物质依赖的参与者比年轻人更有可能家庭收入较低，社会支持较少。
污名化是物质依赖的最强预测因素。我们的研究还证实，男性和年轻人更容易出现物质依赖。需要开展反污名化、预防和外展计划，以克服该人群对使用医疗保健服务的抵触情绪。卫生专业人员还应更加关注新发现的吸毒者的生活和健康感知以及邻里特征。
