Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland.
Schizophr Res. 2018 Nov;201:360-366. doi: 10.1016/j.schres.2018.05.013. Epub 2018 Jun 27.
Cross-sectional studies have suggested inhalant use is associated with psychosis. This association was examined in a longitudinal study accounting for other substance use and potential confounders.
We used a prospective sample (N = 6542) from the Northern Finland Birth Cohort 1986. Self-report questionnaires on substance use and psychotic experiences were completed when the cohort members were 15-16 years old. Inhalant use was categorized into four groups (never, once, 2-4 times, 5 times or more). Subsequent psychosis diagnoses (ICD-10) until age 30 years were obtained from national registers. Cox regression analysis was used to examine the association between adolescent inhalant use and risk of psychosis.
During the observation period 124 individuals were diagnosed with incident psychosis. Overall, there were 225 (3.4%) subjects with any inhalant use, 18 (8.0%) of whom were diagnosed with psychosis during the follow up. Of non-inhalant users (n = 6317) 106 (1.7%) were diagnosed with psychosis. Compared to non-users, those using inhalants had increased risk of incident psychosis with most frequent inhalant use associated with the greatest risk (unadjusted HR = 9.46; 3.86-23.20). After adjusting for baseline psychotic experiences, other substance use, comorbid mental disorder and parental substance abuse, the increased risk of psychosis persisted (HR = 3.06; 1.05-8.95). Furthermore, a dose-response effect between inhalant use and risk of psychosis was identified (OR = 2.34; 1.83-2.99).
Inhalant use in adolescence was independently associated with incident psychosis. The adverse health outcomes associated with adolescent inhalant use provide compelling reasons for implementation of policies to reduce the use of volatile substances in adolescents.
横断面研究表明，吸入剂的使用与精神病有关。本研究通过一项纵向研究，考虑了其他物质的使用和潜在的混杂因素，对这种关联进行了检验。
我们使用了来自 1986 年芬兰北部出生队列的前瞻性样本（N=6542）。当队列成员 15-16 岁时，他们完成了关于物质使用和精神病体验的自我报告问卷。吸入剂的使用分为四组（从未使用、使用过一次、使用过 2-4 次、使用过 5 次或更多次）。随后，通过国家登记处获得了 30 岁前的精神分裂症诊断（ICD-10）。使用 Cox 回归分析来检验青少年使用吸入剂与精神病风险之间的关联。
在观察期间，有 124 人被诊断出患有首发精神病。总的来说，有 225 名（3.4%）受试者使用过任何吸入剂，其中 18 名（8.0%）在随访期间被诊断为精神病。在非吸入剂使用者（n=6317）中，有 106 名（1.7%）被诊断为精神病。与非使用者相比，使用吸入剂者发生首发精神病的风险增加，最频繁使用吸入剂者的风险最大（未调整的 HR=9.46；3.86-23.20）。在调整了基线精神病体验、其他物质使用、合并精神障碍和父母物质滥用后，精神病的风险仍然增加（HR=3.06；1.05-8.95）。此外，还发现了吸入剂使用与精神病风险之间的剂量反应关系（OR=2.34；1.83-2.99）。
青少年时期使用吸入剂与首发精神病独立相关。青少年使用吸入剂所带来的不良健康后果为实施减少青少年挥发性物质使用的政策提供了有力的理由。
