Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Behavioral and Community Health, University of Maryland College Park School of Public Health, College Park, MD, USA.
Drug Alcohol Depend. 2022 Sep 1;238:109566. doi: 10.1016/j.drugalcdep.2022.109566. Epub 2022 Jul 7.
Longitudinal research assessing whether mood disorders predict substance use behaviors is limited. We extend our prior work evaluating transition patterns with alcohol use to assess patterns with alcohol and drug use problems.
Using National Epidemiologic Survey on Alcohol and Related Conditions prospective data, waves 1 and 2, we completed latent class analyses to empirically define classes of alcohol and drug problems from DSM disorder criteria. Latent transition analyses were used to assess associations of lifetime mood disorders at baseline with transitions across classes of alcohol and drug problems during follow-up.
A three-class model of alcohol and drug problems was identified (No problems, Alcohol Problems Only, and Alcohol and Drug Problems) for males and females. Females with mood disorders were over two times more likely to transition from No Problems, and Alcohol Problems Only at baseline to having both Alcohol and Drug Problems at follow-up relative to those without mood disorders (aOR=2.30, 95 % CI=1.31-4.05, p = 0.004, and aOR=2.64, CI=1.24-5.62, p = 0.011, respectively). Furthermore, females with mood disorders were significantly less likely to recover from baseline Alcohol and Drug Problems to Alcohol Problems Only at follow-up (aOR=0.35, CI=0.12-0.98, p = 0.047) relative to those without mood disorders. There were no significant findings for males.
Our study provides evidence that mood disorders impact transitions through classes of alcohol and drug problems among females. The findings emphasize the need for ongoing evaluation of substance use among those with mood conditions, and recognition and treatment of mood disorders among those recovering from substance use problems.
评估心境障碍是否会预测物质使用行为的纵向研究有限。我们扩展了之前评估酒精使用的过渡模式的工作，以评估与酒精和药物使用问题相关的模式。
使用全国酒精相关情况流行病学调查的前瞻性数据，第 1 波和第 2 波，我们完成了潜在类别分析，根据 DSM 障碍标准从经验上定义酒精和药物问题的类别。潜在转移分析用于评估基线时的终身心境障碍与随访期间跨越酒精和药物问题类别的转移之间的关联。
为男性和女性确定了一个三种类别模型的酒精和药物问题（无问题、仅酒精问题和酒精和药物问题）。与没有心境障碍的人相比，有心境障碍的女性更有可能从基线时无问题和仅酒精问题过渡到随访时同时存在酒精和药物问题（OR=2.30，95%CI=1.31-4.05，p=0.004 和 OR=2.64，CI=1.24-5.62，p=0.011）。此外，与没有心境障碍的人相比，有心境障碍的女性从基线时的酒精和药物问题恢复到仅酒精问题的可能性显著降低（OR=0.35，CI=0.12-0.98，p=0.047）。男性没有显著发现。
我们的研究提供了证据表明，心境障碍通过女性的酒精和药物问题类别影响过渡。这些发现强调了需要对有心境障碍的人进行持续的物质使用评估，以及对那些从物质使用问题中恢复的人识别和治疗心境障碍。
