DiMiceli Lauren E, Sherman Susan G, Aramrattana Apinun, Sirirojn Bangorn, Celentano David D
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
BMC Public Health. 2016 Feb 19;16:168. doi: 10.1186/s12889-016-2851-1.
High levels of depressive symptoms often occur among individuals that use or that are dependent on methamphetamine (MA). Thailand is currently experiencing an epidemic of MA use among youth. Understanding the nature of the relationship between depressive symptoms and MA use and identifying those most at risk can further understanding of prevention and treatment options for youth who use MA and present with depressive symptoms.
In 2011, we conducted a cross sectional epidemiologic study that examined associations between MA use and high levels of depressive symptoms among adolescents and young adults aged 14-29 living in Chiang Mai province, Thailand. A combination of cluster and systematic sampling was conducted to obtain a study sample of participants actively recruited in Chiang Mai province. Depressive symptoms were measured using a Thai translation of the Centers for Epidemiologic Studies Depression scale (CES-D). The independent variables measured reported lifetime and recent MA use within the past 3 months. Multivariate logistic regression models were used to assess associations between MA use and high levels of depressive symptoms.
Approximately 19% (n = 394) of the sample reported ever having consumed MA and 31% (n = 124) of lifetime users reported recent MA use within the past 3 months. Recent MA use was associated with high levels of depressive symptoms (aPOR recent use: 2.60, 95% CI: 1.20, 5.63).
This is one of the first studies to examine the association between MA use and high levels of depressive symptoms in a general Thai population. The odds of having high levels of depressive symptoms was significantly greater among recent MA users compared to non-users. These findings support the need for policies, programs and interventions to prevent and treat depressive symptoms presenting among MA using Thai adolescents and young adults in rural Chiang Mai province, Thailand to aid in cessation of MA use. Furthermore, additional research is needed to investigate treatment options for adolescents and young adults in Thailand that use MA and present with high levels of depressive symptoms.
使用甲基苯丙胺（MA）或对其产生依赖的个体中常常出现高水平的抑郁症状。泰国目前正经历青年人群中使用MA的流行趋势。了解抑郁症状与MA使用之间关系的本质，并识别出风险最高的人群，有助于进一步理解针对使用MA且出现抑郁症状的青年的预防和治疗方案。
2011年，我们开展了一项横断面流行病学研究，调查泰国清迈省14至29岁青少年和青年中MA使用与高水平抑郁症状之间的关联。采用整群抽样和系统抽样相结合的方法，获取在清迈省积极招募的研究样本。使用流行病学研究中心抑郁量表（CES-D）的泰语翻译版本测量抑郁症状。所测量的自变量包括报告的终生MA使用情况以及过去3个月内最近的MA使用情况。使用多变量逻辑回归模型评估MA使用与高水平抑郁症状之间的关联。
样本中约19%（n = 394）报告曾使用过MA，终生使用者中有31%（n = 124）报告在过去3个月内有最近的MA使用情况。最近使用MA与高水平抑郁症状相关（最近使用的调整后比值比：2.60，95%置信区间：1.20，5.63）。
这是首批在泰国普通人群中研究MA使用与高水平抑郁症状之间关联的研究之一。与未使用者相比，最近使用MA者出现高水平抑郁症状的几率显著更高。这些发现支持需要制定政策、项目和干预措施，以预防和治疗泰国清迈省农村地区使用MA的青少年和青年中出现的抑郁症状，以帮助他们戒除MA使用。此外，还需要进一步研究，以调查泰国使用MA且出现高水平抑郁症状的青少年和青年的治疗方案。
