门诊治疗中有物质使用问题的青少年：一项为期一年的前瞻性随访研究，重点关注心理健康和性别差异。
Adolescents with substance use problems in outpatient treatment: a one-year prospective follow-up study focusing on mental health and gender differences.
机构信息
Department of Psychology, Inland Norway University of Applied Sciences, PO box 400, NO-2418, Elverum, Norway.
Department of Psychology, University of Gothenburg, PO Box 500, SE-405 30, Gothenburg, Sweden.
出版信息
Subst Abuse Treat Prev Policy. 2022 Jul 15;17(1):53. doi: 10.1186/s13011-022-00482-2.
BACKGROUND
Although several studies have found a high incidence of coexisting mental health problems among adolescents with substance use problems, follow-up studies addressing how these conditions change over time are rare. The study will describe and analyze indications of mental health problems and how various risk factors predict outcomes 1 year after initial treatment contact. In addition, gender-specific risk factors are explored.
METHODS
A clinical sample of 455 adolescents (29% girls, median age 17 years) answered a structural interview at baseline and were followed up using official records 1 year after initiated treatment. Bivariate associations and logistic regressions were conducted to analyse the links between risk factors at the individual, social, and structural levels as well as links between various mental illness symptoms at treatment start and indications of mental health problems 1 year later were analysed.
RESULTS
The results show that mental health problems among adolescents largely persisted 1 year after start of outpatient care for substance use problems. Forty-two per cent of the sample displayed indications of mental health problems at follow-up, and registrations for both outpatient treatment and psychiatric medication were more common among the girls. Girls also reported more mental illness symptoms at treatment start than boys did, especially anxiety. Depression and suicidal thoughts had predictive values regarding indications of mental health problems and small cumulative effects were found for 6-10 co-occurring risk factors.
CONCLUSIONS
Adolescents with depression and suicidal thoughts at treatment start should yield attention among clinicians as these general risk factors could predict indication of mental health problems at 1 year follow-up effectively. Also, patients with more than six co-occurring risk factors seem more vulnerable for continued mental health problems. Generally, girls displayed a greater mental health and psychosocial burden at treatment initiation and were more likely to show indication of mental health problems at follow-up. These results suggests that girls are more likely to get psychiatric out-treatment parallel to, or after, substance abuse treatment. We recommend further investigation of gender differences and gender-specific needs in substance use treatment.
背景
尽管有几项研究发现，患有物质使用问题的青少年同时存在心理健康问题的发生率较高，但很少有随访研究来探讨这些情况随时间的变化。本研究将描述和分析心理健康问题的迹象，并分析各种风险因素如何预测初始治疗接触后 1 年的结果。此外，还探讨了性别特异性的风险因素。
方法
一个由 455 名青少年组成的临床样本（29%为女孩，中位年龄 17 岁）在基线时接受了结构访谈，并在开始治疗后 1 年使用官方记录进行了随访。进行了双变量关联和逻辑回归分析，以分析个体、社会和结构层面的风险因素之间的联系，以及治疗开始时各种精神疾病症状与 1 年后心理健康问题迹象之间的联系。
结果
结果表明，青少年的心理健康问题在开始接受物质使用问题的门诊治疗后 1 年仍普遍存在。42%的样本在随访时显示出心理健康问题的迹象，女孩中接受门诊治疗和精神科药物治疗的比例更高。女孩在治疗开始时报告的精神疾病症状也比男孩多，尤其是焦虑。抑郁和自杀念头与心理健康问题的迹象有预测价值，发现 6-10 个共病风险因素有小的累积效应。
结论
在治疗开始时出现抑郁和自杀念头的青少年应该引起临床医生的关注，因为这些一般风险因素可以有效地预测 1 年随访时的心理健康问题迹象。此外，共病风险因素超过 6 个的患者似乎更容易出现持续的心理健康问题。一般来说，女孩在治疗开始时表现出更大的心理健康和心理社会负担，并且在随访时更有可能表现出心理健康问题的迹象。这些结果表明，女孩在物质滥用治疗的同时或之后更有可能接受精神科的额外治疗。我们建议进一步调查性别差异和物质使用治疗中的性别特异性需求。
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