Fidalgo Thiago M, Sanchez Zila M, Caetano Sheila C, Maia Lucas O, Carlini Elisaldo A, Martins Silvia S
Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.
Department of Preventive Medicine, Brazilian Center of Information on Psychotropic Drugs (CEBRID), Universidade Federal de São Paulo, São Paulo, Brazil.
Am J Addict. 2016 Aug;25(5):416-25. doi: 10.1111/ajad.12407. Epub 2016 Jul 20.
Studies have highlighted psychosocial factors associated with drug use among adolescents. Association of specific psychiatric comorbidity with substance use has not been properly established in Brazil. This study aimed to investigate alcohol, tobacco, and marijuana use by 15-18-year-old high school Brazilian students and to estimate associations with psychiatric symptoms.
A cross-sectional survey of 4,034 students from 128 public and private schools in São Paulo State was carried out using a two-step probability sample. Data were collected through self-report standardized questionnaires including questions on substance use patterns and the Strengths and Difficulties Questionnaire (SDQ). Key outcome variables were past-month use and past-month frequent use of alcohol, tobacco and marijuana. Questionnaires with missing information were excluded, resulting in a final sample of 2,532 adolescents. Weighted data was analyzed through logistic regressions, adjusted by gender and by socio-economic status (SES).
Regarding SDQ total score, 43.6% of students had no psychiatric symptoms, 7.9% had subclinical symptoms and 48.5% presented clinically significant symptoms. Respondents with a clinically significant SDQ score were more likely to be past month alcohol (aOR = 1.51; 95%CI 1.22-1.88), tobacco (aOR = 1.82; 95%CI 1.25-2.66), and marijuana (aOR = 1.79; 95%CI 1.21-2.64) users as compared to those with no symptomatology.
Psychopathological symptoms were associated with alcohol, tobacco and marijuana use by 15-18-year-old adolescents. These associations should also be considered when planning public policies of mental health promotion.
This study discusses the importance of the association between psychopathological symptoms and substance use in a middle-income country, with high level of social inequalities, in a state representative sample. (Am J Addict 2016;25:416-425).
研究强调了与青少年药物使用相关的社会心理因素。在巴西，特定精神疾病合并症与物质使用之间的关联尚未得到妥善确立。本研究旨在调查巴西15至18岁高中生的酒精、烟草和大麻使用情况，并评估其与精神症状的关联。
采用两步概率抽样法，对圣保罗州128所公立和私立学校的4034名学生进行了横断面调查。通过自我报告标准化问卷收集数据，问卷包括关于物质使用模式的问题以及优势与困难问卷（SDQ）。关键结局变量为过去一个月内酒精、烟草和大麻的使用情况以及过去一个月内的频繁使用情况。排除信息缺失的问卷，最终样本为2532名青少年。通过逻辑回归分析加权数据，并按性别和社会经济地位（SES）进行调整。
关于SDQ总分，43.6%的学生没有精神症状，7.9%有亚临床症状，48.5%有临床显著症状。与无症状的受访者相比，SDQ得分具有临床显著性的受访者过去一个月内更有可能使用酒精（调整后比值比[aOR]=1.51；95%置信区间[CI] 1.22 - 1.88）、烟草（aOR = 1.82；95%CI 1.25 - 2.66）和大麻（aOR = 1.79；95%CI 1.21 - 2.64）。
精神病理症状与15至18岁青少年的酒精、烟草和大麻使用有关。在制定促进心理健康的公共政策时，也应考虑这些关联。
本研究在一个社会不平等程度高的中等收入国家，以一个具有代表性的州样本，探讨了精神病理症状与物质使用之间关联的重要性。（《美国成瘾杂志》2016年；25:416 - 425）
