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作为年轻或年长的成年人进入康复期对长期功能和生活质量的独立影响:来自美国康复人群全国研究的结果。

Independent effects of entering recovery as a young versus older adult on long-term functioning and quality of life: Results from a U.S. national study of recovering persons.

机构信息

Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Harvard Medical School, Boston, MA, 02114, United States.

Department of Psychiatry, Columbia University, New York, NY, United States.

出版信息

Drug Alcohol Depend. 2021 Feb 1;219:108493. doi: 10.1016/j.drugalcdep.2020.108493. Epub 2020 Dec 24.

Abstract

BACKGROUND

For physical health conditions, earlier intervention typically results in better prognoses and improved quality of life (QoL). Despite some evidence that early intervention yields better subsequent functioning too for behavioral health conditions like alcohol and other drug (AOD) disorders, less is known. This study examined the relationship between the life-stage at which individuals entered AOD recovery, demographic and clinical correlates, and its relationship to a variety of indices of current functioning, QoL and well-being.

METHOD

Nationally representative sample of U.S. adults who resolved an AOD problem (Weighted N = 1844). Structured regression analyses tested whether life-stage at which individuals entered recovery (i.e., as a young [18-30yrs,n = 746] vs. older [>30yrs,n = 1098] adult), was associated with current QoL, happiness, self-esteem, distress, and recovery capital, independent of confounders. Sensitivity analyses investigated effects during the first 5-years of recovery.

RESULTS

Young adult recovery entry was independently associated with current employment, younger age of onset for primary substance, primary substance other than alcohol, and less lifetime psychiatric comorbidity. In fully-adjusted models examining indices of functioning, no association was found between life-stage at recovery entry and current self-esteem, happiness, or distress, but an association was found between young adult recovery entry and better current functioning and QoL. This effect was even more pronounced during the first 5-years of recovery.

CONCLUSION

Irrespective of current age, duration of recovery, and clinical markers of impairment, entering recovery as a young, versus older, adult, is associated with better subsequent QoL - an advantage that appears even more discernable early in recovery.

摘要

背景

对于身体健康状况,早期干预通常会带来更好的预后和更高的生活质量(QoL)。尽管有一些证据表明,对于酒精和其他药物(AOD)障碍等行为健康状况,早期干预也会产生更好的后续功能,但了解得较少。本研究考察了个体进入 AOD 康复的生命阶段、人口统计学和临床相关性及其与各种当前功能、QoL 和幸福感指数之间的关系。

方法

对美国解决 AOD 问题的成年人进行了全国代表性抽样(加权 N = 1844)。结构回归分析检验了个体进入康复的生命阶段(即年轻[18-30 岁,n = 746]与年龄较大[>30 岁,n = 1098]的成年人)是否与当前 QoL、幸福感、自尊、困扰和康复资本有关,而与混杂因素无关。敏感性分析调查了康复前 5 年的影响。

结果

年轻成年人的康复进入与当前就业、主要物质的发病年龄较小、除酒精以外的主要物质以及较少的终身精神共病有关。在全面调整的功能指标模型中,康复进入的生命阶段与当前自尊、幸福感或困扰之间没有关联,但在年轻成年人的康复进入与当前功能和 QoL 之间存在关联。这种影响在康复的前 5 年更为明显。

结论

无论当前年龄、康复持续时间和临床损伤标志物如何,作为年轻成年人而非年龄较大的成年人进入康复与更好的后续 QoL 相关——这种优势在康复早期更为明显。

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