Smith Joshua R, Hazen Eric P, Kaminski Tamar A, Wilens Timothy E
Division of Child and Adolescent Psychiatry, Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, United States..
Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, United States..
Gen Hosp Psychiatry. 2020 Nov-Dec;67:115-126. doi: 10.1016/j.genhosppsych.2020.10.002. Epub 2020 Oct 12.
Pediatric and young adult patients frequently present to medical inpatient (MIP) units for treatment of substance use disorder (SUD). Given the risk of lifelong dependence and related complications in early life substance use (SU), a review of the literature is warranted.
We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic review of literature published through April, 62,020, which examined incidence, screening, and complications of pediatric and young adult SU in the MIP setting.
8843 articles were screened, and 28 articles were included for final qualitative synthesis. The overall prevalence of SU-related discharge diagnoses ranged from 1.3% to 5% for patients aged 0 to 26 years. When compared to adult patients, nearly double the rate of co-morbid psychopathology was observed. Three studies utilized systematic screening tools, with the remainder relying on biologic screens and admission or discharge diagnoses.
The results of our review indicate that current screening practices for SU in the MIP clinical setting are subpar and likely result in an underestimation of incidence and morbidity due to limited use of systematic screening tools. Despite this, incidence of SU hospitalizations and related medical and psychiatric complications continue to rise.
儿科和年轻成年患者经常前往医疗住院部（MIP）接受物质使用障碍（SUD）治疗。鉴于早期物质使用（SU）存在终身依赖及相关并发症的风险，有必要对文献进行综述。
我们对截至2020年4月发表的文献进行了一项系统评价和Meta分析的首选报告项目（PRISMA）系统综述，该综述考察了MIP环境下儿科和年轻成年SU的发病率、筛查及并发症情况。
共筛选了8843篇文章，28篇文章被纳入最终的定性综合分析。0至26岁患者中与SU相关的出院诊断总体患病率为1.3%至5%。与成年患者相比，共病精神病理学发生率几乎高出一倍。三项研究使用了系统筛查工具，其余研究则依赖生物学筛查以及入院或出院诊断。
我们的综述结果表明，MIP临床环境中目前对SU的筛查做法欠佳，由于系统筛查工具使用有限，可能导致对发病率和患病率的低估。尽管如此，SU住院率以及相关的医疗和精神并发症仍在持续上升。
