Fernandez-Pol B, Bluestone H, Mizruchi M S
Department of Psychiatry, Bronx-Lebanon Hospital Center, New York 10467.
Am J Drug Alcohol Abuse. 1988;14(1):41-50. doi: 10.3109/00952998809001534.
Multiple studies have reported about substance abuse in Blacks and Hispanics. However, little is known about substance-abusing psychiatric patients of these ethnic groups. This study reports the prevalence and patterns of substance abuse among 171 consecutive patients (90 Blacks and 81 Hispanics) admitted to the acute psychiatric unit of an inner-city general hospital. The lifetime prevalence was 63%. Within the month prior to admission, 48% had used the following substances: cannabis, 40%; alcohol, 37%; amphetamines, 20%; cocaine, 12%; phencyclidine (PCP), 12%; barbiturates and/or sedative-hypnotics, 10%; opioids, 9%; inhalants, 1%; hallucinogens, 1%. Those who abused alcohol were more likely to abuse barbiturates and/or sedative-hypnotics, and opioids. Logistic regression analysis showed that major depression, ethnicity, and schizophrenia each were significant predictors of particular types of abuse. Patients with major depression were less likely to use PCP, Blacks were more likely than Hispanics to use hallucinogens, and schizophrenics were less likely to use opioids. In all cases in which sex, age, and personality disorder were significant, males, the young adult group, and those with personality disorder were more likely to be abusers. These three variables were all strong predictors of both multiple and extensive substance abuse. Overall, our findings suggest that in the inner-city, a substantial number of young adult psychiatric inpatients are a high risk group for multiple substance abuse. The coexistence of substance abuse and other psychiatric disorders has clinical and treatment implications, and calls attention for changes within the conventional psychiatric milieu.
多项研究报告了黑人和西班牙裔中的药物滥用情况。然而，对于这些种族中存在药物滥用问题的精神病患者却知之甚少。本研究报告了一家市中心综合医院急性精神科收治的171例连续患者（90名黑人患者和81名西班牙裔患者）中药物滥用的患病率及模式。终生患病率为63%。在入院前一个月内，48%的患者使用过以下物质：大麻，40%；酒精，37%；苯丙胺，20%；可卡因，12%；苯环己哌啶（PCP），12%；巴比妥类药物和/或镇静催眠药，10%；阿片类药物，9%；吸入剂，1%；致幻剂，1%。滥用酒精的患者更有可能滥用巴比妥类药物和/或镇静催眠药以及阿片类药物。逻辑回归分析表明，重度抑郁症、种族和精神分裂症各自都是特定类型药物滥用的显著预测因素。患有重度抑郁症的患者使用PCP的可能性较小，黑人使用致幻剂的可能性高于西班牙裔，而精神分裂症患者使用阿片类药物的可能性较小。在性别、年龄和人格障碍具有显著影响的所有案例中，男性、青年成人组以及患有人格障碍的人更有可能成为滥用者。这三个变量都是多种药物滥用和广泛药物滥用的强有力预测因素。总体而言，我们的研究结果表明，在市中心，大量年轻成人精神科住院患者是多种药物滥用的高危人群。药物滥用与其他精神障碍的共存具有临床和治疗意义，并呼吁对传统精神科环境进行变革。
