Hassan Ahmed N, Le Foll Bernard
Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
J Clin Psychiatry. 2021 Jul 27;82(5):20m13637. doi: 10.4088/JCP.20m13637.
This study aimed to estimate the survival probabilities related to the occurrence of major depressive episodes (MDEs) after the onset of substance use disorders (SUDs) using data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 was used to diagnose SUD, and psychiatric diagnoses were based on the , Fifth Edition. Individuals with incidents of various SUDs with no prior history of MDEs (n = 5,987 with alcohol use disorder [AUD], 1,353 with cannabis use disorder [CUD], 351 with opioid use disorder [OUD], 827 with stimulant use disorder [STUD], and 5,363 with nicotine use disorder [NUD]) were included. The survival probabilities of these groups were compared to those of a control group without an SUD (n = 20,034). Outcome measures included the number of years from the age at SUD onset until MDE occurrence or the time of the interview. The probabilities of experiencing MDEs after 1 year were 3.56%, 4.80%, 7.78%, 8.46%, and 5.31% for AUD, CUD, OUD, STUD, and NUD, respectively. The groups differed statistically significantly from each other and from the control group ( < .0001). Individuals with AUD and STUD, respectively, had a lower and higher probability of having an MDE compared to those with other SUDs. Young age, family history of depression, anxiety disorder presence, and failure to achieve full remission consistently predicted an MDE for all substances. The findings highlight that users of all studied substances have an increased probability of having an MDE over the lifespan.
本研究旨在利用2012 - 2013年全国酒精及相关疾病流行病学调查三期的数据，估计物质使用障碍（SUDs）发病后与重度抑郁发作（MDEs）发生相关的生存概率。使用酒精使用障碍及相关残疾访谈表-5来诊断SUDs，精神疾病诊断基于《精神疾病诊断与统计手册》第五版。纳入了各类SUDs发病且无MDEs既往史的个体（n = 5987例酒精使用障碍[AUD]、1353例大麻使用障碍[CUD]、351例阿片类物质使用障碍[OUD]、827例兴奋剂使用障碍[STUD]以及5363例尼古丁使用障碍[NUD]）。将这些组的生存概率与无SUDs的对照组（n = 20034）进行比较。结局指标包括从SUD发病年龄到MDE发生或访谈时间的年数。AUD、CUD、OUD、STUD和NUD在1年后发生MDEs的概率分别为3.56%、4.80%、7.78%、8.46%和5.31%。这些组之间以及与对照组在统计学上有显著差异（P <.0001）。与其他SUDs患者相比，AUD和STUD患者发生MDE的概率分别较低和较高。年轻、有抑郁症家族史、存在焦虑障碍以及未能完全缓解一直是所有物质导致MDE的预测因素。研究结果突出表明，所有研究物质的使用者在一生中发生MDE的概率都会增加。
