a Assistant Professor of Psychiatry, Department of Psychiatry , Weill Institute for Neurosciences, and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco , San Francisco , CA , USA.
b Postdoctoral Scholar, Department of Psychiatry and Weill Institute for Neurosciences , University of California, San Francisco , San Francisco , CA , USA.
J Psychoactive Drugs. 2018 Jan-Mar;50(1):43-53. doi: 10.1080/02791072.2017.1401185. Epub 2017 Dec 4.
Substance use, psychiatric problems, and pain frequently co-occur, yet clinical profiles of treatment-seeking patients are poorly understood. To inform service and treatment planning, substance use and symptom patterns were examined in an outpatient psychiatry clinic, along with the relationship of these patterns to demographic characteristics and physical health.
Patients (N = 405; age M = 38; 69% White; 60% female) presenting for intake in a psychiatry outpatient clinic completed a computerized assessment of psychiatric problems, drinking, and drug use. Substance use and psychiatric symptom patterns among the sample were identified using latent class analysis.
A 4-class model fit the data best: Class (1) Moderate symptoms/wide-range users (22.0%) had moderate depression and panic; tobacco, cocaine, hallucinogen, and ecstasy use; and high cannabis use. Class (2) Moderate depression/panic (37.8%) had moderate depression and panic. Class (3) Depression/anxiety, tobacco, and cannabis users (28.0%) had high depression, obsessions, and panic, and moderate pain severity, social phobia, compulsions, trauma, tobacco, and cannabis use. Class (4) Severe/wide range symptoms/users (12.0%) had high panic, depression, social phobia, obsessions, drug use, and moderate pain. Gender, ethnicity, and health status varied by class.
Findings highlight the preponderance of substance use (particularly cannabis) and its relationship to psychiatric symptom severity, pain, and health status among those presenting for mental health treatment.
物质使用、精神健康问题和疼痛经常同时出现，但寻求治疗的患者的临床特征仍了解甚少。为了提供服务和治疗计划的信息，本研究在一家精神病门诊诊所检查了物质使用和症状模式，以及这些模式与人口统计学特征和身体健康的关系。
（N=405；年龄 M=38；69%为白人；60%为女性）在精神病门诊诊所就诊的患者完成了一份关于精神健康问题、饮酒和药物使用的计算机评估。使用潜在类别分析确定了样本中的物质使用和精神症状模式。
一个 4 类模型最适合数据：第 1 类（中度症状/广泛使用）（22.0%）有中度抑郁和惊恐；烟草、可卡因、致幻剂和摇头丸使用；大麻使用量较高。第 2 类（中度抑郁/惊恐）（37.8%）有中度抑郁和惊恐。第 3 类（抑郁/焦虑、烟草和大麻使用者）（28.0%）有高度抑郁、强迫观念、惊恐，以及中度疼痛严重程度、社交恐惧症、强迫观念、创伤、烟草和大麻使用。第 4 类（严重/广泛症状/使用者）（12.0%）有高度惊恐、抑郁、社交恐惧症、强迫观念、药物使用和中度疼痛。性别、种族和健康状况因类别而异。
研究结果突出了物质使用（尤其是大麻）的普遍性及其与精神健康症状严重程度、疼痛和健康状况之间的关系，这对于那些寻求心理健康治疗的人来说是非常重要的。
