在瑞典青少年社区样本中的流行率和共病现象——赌博、游戏、物质使用和其他精神障碍。
Prevalence and comorbidity in a Swedish adolescent community sample - gambling, gaming, substance use, and other psychiatric disorders.
机构信息
School of Health and Welfare, Department of Social Work, Jönköping University, Box 1026, 551 11, Jönköping, Sweden.
Department of Medical Sciences Lund, Lund University, Psychiatry, Lund, Sweden.
出版信息
BMC Psychiatry. 2022 Sep 6;22(1):594. doi: 10.1186/s12888-022-04218-1.
BACKGROUND
This study investigates a broad spectrum of psychiatric disorders, substance use disorders, gambling, and internet gaming disorders in Swedish 18-year-old boys and girls with the aim of estimating the prevalence of disorders and comorbidity.
METHODS
We used a two-phase design with screening to detect candidates for clinical interviews. Screening included 949 adolescents (55.6% girls), out of which 758 adolescents (57.0% girls) were selected for interview with at least one of four instruments: M.I.N.I., ADDIS, NODS and IGDS. Of these, 387 (61.2% girls) were interviewed. Gender separated prevalence was estimated on the assumption that those selected but not interviewed had the same distribution as those interviewed based on similar outcomes above screening cut-offs. Comorbidity between types of disorders was estimated on similar assumptions. In addition, comorbidity between dyads of the ten most common specified disorders was calculated based on recorded data without these assumptions.
RESULTS
We estimated that 14.6% met the criteria of a substance use disorder (SUD), mostly concerning alcohol and more frequent in girls than in boys. Those meeting the criteria lifetime of at least one of 16 other psychiatric disorders were 26.7%, more than twice as frequent in girls compared to boys, and with depression being the most common disorder. Gambling and gaming disorders were found almost exclusively in boys, of which 5.8% met the criteria for gambling, and 2.3% for gaming disorders. Of girls with a SUD, 40% also had a psychiatric disorder, while on the other hand more than 28% of girls with a psychiatric disorder also had a SUD. In boys with a SUD, 22% had another psychiatric disorder, while 15% of those with a psychiatric disorder also had a SUD.
CONCLUSIONS
Psychiatric comorbidity is common in SUDs in adolescents, which calls for screening and diagnostic efforts in young patients presenting with symptoms of SUDs. Girls with SUDs are at higher risk of also suffering from psychiatric conditions. Gambling and gaming disorders appear in a substantial minority of adolescents and warrant further study of their comorbidity. Since prevalences and comorbidity were estimated on the assumptions mentioned, some caution in interpreting the results is needed.
背景
本研究旨在估计瑞典 18 岁男孩和女孩中广泛的精神障碍、物质使用障碍、赌博和网络游戏障碍的患病率，并调查这些障碍的共病情况。
方法
我们采用了两阶段设计，包括筛查以发现有临床访谈候选人。筛查包括 949 名青少年（55.6%为女孩），其中 758 名青少年（57.0%为女孩）选择使用至少一种四种工具（MINI、ADDIS、NODS 和 IGDS）进行访谈。其中 387 名（61.2%为女孩）接受了访谈。根据相似的结果，我们假设那些被选择但未接受访谈的人在筛查截止值以上与接受访谈的人具有相同的分布，以此来估计性别分开的患病率。基于类似的假设，我们还估计了不同类型障碍之间的共病情况。此外，根据记录的数据，我们在不做这些假设的情况下，计算了十种最常见特定障碍的对偶共病。
结果
我们估计有 14.6%的人符合物质使用障碍（SUD）的标准，主要涉及酒精，且在女孩中比男孩更为常见。那些符合至少 16 种其他精神障碍终身标准的人占 26.7%，女孩比男孩更为常见，其中最常见的障碍是抑郁症。赌博和游戏障碍几乎仅在男孩中发现，其中 5.8%符合赌博障碍的标准，2.3%符合游戏障碍的标准。患有 SUD 的女孩中，40%也患有精神障碍，而另一方面，患有精神障碍的女孩中超过 28%也患有 SUD。患有 SUD 的男孩中，22%有另一种精神障碍，而患有精神障碍的男孩中有 15%也患有 SUD。
结论
青少年的 SUD 中常见精神共病，这呼吁对出现 SUD 症状的年轻患者进行筛查和诊断。患有 SUD 的女孩患精神疾病的风险更高。赌博和游戏障碍在相当一部分青少年中出现，需要进一步研究它们的共病情况。由于患病率和共病情况是根据上述假设估计的，因此在解释结果时需要谨慎。
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