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青少年期至中年期心理症状与重度间歇性饮酒之间的纵向前瞻性关联。

Longitudinal prospective associations between psychological symptoms and heavy episodic drinking from adolescence to midlife.

机构信息

1 Uppsala University, Uppsala, Sweden.

2 National Institute for Health and Welfare, Helsinki, Finland.

出版信息

Scand J Public Health. 2019 Jun;47(4):420-427. doi: 10.1177/1403494818769174. Epub 2018 Apr 12.

Abstract

AIM

This study examined whether development of psychological symptoms (PS) differed between persons with different longitudinal profiles of heavy episodic drinking (HED) from adolescence to midlife. In addition, the reciprocal associations between PS and HED were studied.

METHODS

Participants of a Finnish cohort study in 1983 at age 16 ( N = 2194) were followed up at ages 22 ( N = 1656), 32 ( N = 1471), and 42 ( N = 1334). HED was assessed with frequency of intoxication (16-22 years) and having six or more drinks in a session (32-42 years). Using latent class analysis, the participants were allocated to steady high, increased, moderate, and steady low groups according to their longitudinal profiles of HED. The PS scale (16-42 years) covered five mental complaints. The latent growth curve of PS was estimated in the HED groups for comparisons. In addition, the prospective associations between symptoms and HED were examined using cross-lagged autoregressive models.

RESULTS

PS grew from 16 to 32 years, but declined after that, with women having higher level of PS than men. PS trajectory followed a path at highest and lowest level in the steady high and steady low HED groups, respectively. Symptoms predicted later HED, but the association in the opposite direction was not found.

CONCLUSIONS

The more the HED trajectory indicated frequent HED, the higher was the level of PS throughout the follow-up. Results support the self-medication hypothesis, suggesting that alcohol is used to ease the burden of PS. More attention should be paid to alcohol use of people with mental symptoms in health services.

摘要

目的

本研究旨在探讨从青少年到中年期间,具有不同重度间断性饮酒(HED)纵向轨迹的个体是否存在心理症状(PS)的发展差异。此外,还研究了 PS 与 HED 之间的相互关联。

方法

这项芬兰队列研究于 1983 年在参与者 16 岁(N=2194)时进行,随访至 22 岁(N=1656)、32 岁(N=1471)和 42 岁(N=1334)。使用醉酒频率(16-22 岁)和单次饮酒 6 杯或以上(32-42 岁)评估 HED。通过潜在类别分析,根据 HED 的纵向轨迹,将参与者分配到稳定高、增加、中度和稳定低组。PS 量表(16-42 岁)涵盖了五种精神抱怨。在 HED 组中,对 PS 的潜在增长曲线进行了估计,以进行比较。此外,还使用交叉滞后自回归模型检查了症状与 HED 之间的前瞻性关联。

结果

PS 从 16 岁增长到 32 岁,但之后下降,女性的 PS 水平高于男性。PS 轨迹在稳定高和稳定低 HED 组中分别遵循最高和最低水平的路径。症状预测了以后的 HED,但没有发现相反方向的关联。

结论

HED 轨迹越频繁地表明 HED 程度越高,整个随访期间 PS 的水平就越高。结果支持自我用药假说,表明酒精被用来缓解 PS 的负担。在卫生服务中,应该更加关注有精神症状的人的酒精使用情况。

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