Romanowicz Magdalena, Vande Voort Jennifer L, Shekunov Julia, Oesterle Tyler S, Thusius Nuria J, Rummans Teresa A, Croarkin Paul E, Karpyak Victor M, Lynch Brian A, Schak Kathryn M
1Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 USA.
Fountain Centers, Mayo Clinic Health System in Albert Lea, Albert Lea, MN USA.
Child Adolesc Psychiatry Ment Health. 2019 Jan 12;13:5. doi: 10.1186/s13034-019-0266-3. eCollection 2019.
Between 2009 and 2014, nearly 3% of US children (age ≤ 17 years) lived in households with at least 1 parent with substance use disorder. The present systematic review aimed to evaluate effects of parental opioid use disorder on the parent-child relationship and child developmental and behavioral outcomes.
Several databases were comprehensively searched for studies published from January 1980 through February 2018 that reviewed effects of parental opioid addiction on parent-child relationships and outcomes of children (age, 0-16 years).
Of 304 unique studies, 12 evaluated effects of parental opioid addiction on the parent-child relationship as the primary outcome and on children's outcomes, including behaviors and development. Observation of mother-child interaction showed that mothers with opioid use disorders are more irritable, ambivalent, and disinterested while showing greater difficulty interpreting children's cues compared with the control group. Children of parents with opioid use disorders showed greater disorganized attachment; they were less likely to seek contact and more avoidant than children in the control group. The children also had increased risk of emotional and behavioral issues, poor academic performance, and poor social skills. Younger children had increased risk of abuse or neglect, or both, that later in life may lead to such difficulties as unemployment, legal issues, and substance abuse.
Current evidence shows association between parental opioid addiction and poorer mother-child attachment and suboptimal child developmental and behavioral outcomes. Further research and treatment targeting children and families with parental opioid use are needed to prevent difficulties later in life.
2009年至2014年期间，近3%的美国儿童（年龄≤17岁）生活在至少有1名患有物质使用障碍的父母的家庭中。本系统评价旨在评估父母阿片类药物使用障碍对亲子关系以及儿童发育和行为结果的影响。
全面检索了多个数据库，以查找1980年1月至2018年2月发表的研究，这些研究回顾了父母阿片类药物成瘾对亲子关系和儿童（年龄0至16岁）结局的影响。
在304项独特的研究中，有12项评估了父母阿片类药物成瘾对亲子关系作为主要结局以及对儿童结局（包括行为和发育）的影响。对母婴互动的观察表明，与对照组相比，患有阿片类药物使用障碍的母亲更易怒、矛盾和冷漠，同时在解读儿童线索方面表现出更大的困难。患有阿片类药物使用障碍的父母的孩子表现出更大的依恋混乱；与对照组的孩子相比，他们寻求接触的可能性更小，回避行为更多。这些孩子还面临情绪和行为问题、学业成绩差以及社交技能差的风险增加。年龄较小的儿童遭受虐待或忽视或两者兼有的风险增加，这在以后的生活中可能导致失业、法律问题和药物滥用等困难。
目前的证据表明，父母阿片类药物成瘾与较差的母婴依恋以及儿童发育和行为结局不理想之间存在关联。需要针对有父母阿片类药物使用问题的儿童和家庭进行进一步的研究和治疗，以预防日后生活中的困难。
