Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Department of Public Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Early Interv Psychiatry. 2018 Jun;12(3):339-347. doi: 10.1111/eip.12330. Epub 2016 Apr 1.
Comorbid substance use, particularly cannabis among adolescents with mental illness, is a major public health concern in developing countries with limited mental health resources. Better understanding of the association between cannabis use and other polysubstance use and early mental illness will provide for more targeted early interventions.
This aim of this study was to examine the socio-demographic profile and cannabis use characteristics among adolescents with first-episode early-onset psychosis (EOP) and compare with age-matched and gender-matched adolescents with first-episode non-psychotic mental illness (controls).
Forty-five adolescents with first-episode EOP and 45 controls were assessed using a clinical interview, Positive and Negative Syndrome Scale and World Health Organization Alcohol, Smoking and Substance Involvement Screening test (ASSIST) for substance-related problems.
There were significant socio-demographic differences among the adolescents with EOP (73% Black, 64% from low family income, 44% from rural areas) compared with controls (24% Black, 53% from low family income, 2% from rural areas). Although there was no difference in lifetime cannabis use, EOP adolescents differed in motivation for cannabis use, had increased current cannabis use (38%, P = 0.01) and more frequent use (52%, P = 0.04) compared with controls (16% current and 18% frequent use). EOP adolescents reported more hazardous use with higher ASSIST mean cannabis-specific involvement scores (EOP 10,2; controls 2,3; P = 0.004).
The differences in socio-demographic variables may reflect the marked disparity in access to mental health care for rural Black youth. Psychotic youth may be more vulnerable to comorbid cannabis-related problems than other mentally ill adolescents. The study highlights the need for early introduction of substance use interventions among adolescents with mental illness.
在精神卫生资源有限的发展中国家，患有精神疾病的青少年同时存在物质使用障碍，尤其是大麻，这是一个主要的公共卫生关注点。更好地了解大麻使用与其他多种物质使用和早期精神疾病之间的关系，将为更有针对性的早期干预措施提供依据。
本研究旨在检查首发早发性精神病（EOP）青少年的社会人口学特征和大麻使用特征，并与年龄和性别匹配的首发非精神病性精神障碍（对照组）青少年进行比较。
使用临床访谈、阳性和阴性综合征量表以及世界卫生组织酒精、吸烟和物质使用问题筛查测试（ASSIST）对 45 名首发 EOP 青少年和 45 名对照组进行评估。
与对照组相比（黑人占 24%，来自低收入家庭的占 53%，来自农村地区的占 2%），EOP 青少年在社会人口统计学方面存在显著差异（黑人占 73%，来自低收入家庭的占 64%，来自农村地区的占 44%）。尽管一生中使用大麻的情况没有差异，但 EOP 青少年使用大麻的动机不同，当前使用大麻的频率更高（38%，P=0.01），使用更频繁（52%，P=0.04），与对照组相比（当前使用 16%，频繁使用 18%）。EOP 青少年报告的危险使用更多，ASSIST 平均大麻特异性参与评分更高（EOP 10.2；对照组 2.3；P=0.004）。
社会人口统计学变量的差异可能反映了农村黑人青年获得精神卫生保健的显著差异。精神病青少年可能比其他精神疾病青少年更容易出现共病大麻相关问题。该研究强调了需要在患有精神疾病的青少年中尽早引入物质使用干预措施。
