Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York.
Department of Psychology, Willamette University, Salem, Oregon.
J Clin Psychiatry. 2022 Dec 28;84(1):22m14420. doi: 10.4088/JCP.22m14420.
There is a high prevalence of prescription stimulant misuse (PSM) among college students in the United States (US). Preventing and identifying PSM requires an understanding of risk factors and correlates, but large-scale surveys regarding this issue have been lacking. We present the largest multi-institution study to date on the correlates of PSM among US college students. We performed a secondary analysis of the 2017 American College Health Association-National College Health Assessment (ACHA-NCHA), an annual national survey on the demographics, health, and academic experiences of US college students. Logistic regression models examined associations between past-year PSM in 40,645 undergraduate college students and hypothesized risk factors. PSM was reported in 8% of college students. PSM was associated with past-year diagnosis or treatment of depression (adjusted odds ratio [AOR] = 1.16; 99% CI, 1.01-1.33), anorexia (AOR = 1.44; 99% CI, 1.02-2.03), attention-deficit/hyperactivity disorder (AOR = 1.66; 99% CI, 1.41-1.95), and substance use disorder/other addiction (AOR = 1.79; 99% CI, 1.30-2.46). The odds of PSM were 5.5 times higher for students who endorsed past-month use of "Legal drugs" and 8 times higher for students who endorsed past-month use of "Illegal drugs" than for those who did not. Other factors associated with PSM included academic difficulty, daytime sleepiness, fraternity or sorority involvement, White race, and cis-male gender. This study identifies many potential risk factors for PSM among US undergraduate college students. Targeted outreach, prevention, and clinical management are discussed. As the COVID-19 pandemic has exacerbated psychiatric distress, sleep difficulties, substance use, and attentional challenges among college students, this study may serve as a baseline for future studies examining the impact of COVID-19 on PSM among college students.
在美国，大学生中普遍存在处方兴奋剂滥用（PSM）的现象。预防和识别 PSM 需要了解风险因素和相关因素，但在这方面缺乏大规模的调查。我们提出了迄今为止关于美国大学生 PSM 的相关性的最大规模多机构研究。我们对 2017 年美国大学生健康协会-全国大学生健康评估（ACHA-NCHA）进行了二次分析，这是一项关于美国大学生人口统计、健康和学术经历的年度全国调查。逻辑回归模型检查了 40645 名大学生过去一年 PSM 与假设风险因素之间的关联。8%的大学生报告了 PSM。PSM 与过去一年诊断或治疗抑郁症（调整后的优势比 [AOR] = 1.16；99%CI，1.01-1.33）、厌食症（AOR = 1.44；99%CI，1.02-2.03）、注意力缺陷/多动障碍（AOR = 1.66；99%CI，1.41-1.95）和物质使用障碍/其他成瘾（AOR = 1.79；99%CI，1.30-2.46）有关。与没有使用的学生相比，过去一个月使用“合法药物”的学生发生 PSM 的几率高 5.5 倍，过去一个月使用“非法药物”的学生发生 PSM 的几率高 8 倍。与 PSM 相关的其他因素包括学业困难、白天嗜睡、兄弟会或姐妹会参与、白种人种族和 cis 男性性别。这项研究确定了许多美国大学生发生 PSM 的潜在风险因素。讨论了针对性的外展、预防和临床管理。由于 COVID-19 大流行加剧了大学生的精神困扰、睡眠困难、药物使用和注意力挑战，这项研究可能成为未来研究 COVID-19 对大学生 PSM 影响的基线。
