Karsberg Sidsel H, Del Palacio-Gonzalez Adriana, Pedersen Michael M, Frederiksen Kirsten S, Pedersen Mads U
Aarhus University, Aarhus, Denmark.
Nordisk Alkohol Nark. 2023 Oct;40(5):520-535. doi: 10.1177/14550725231170950. Epub 2023 May 24.
This study prospectively examined the association between adverse experiences (physical abuse, sexual abuse and parental substance use problems [SUPs]), not being employed, in education or training (NEET) and being in need of acute psychiatric help among patients receiving treatment for substance use disorders. A total of 580 adolescents and early adults aged 15-25 years enrolled in treatment for drug use disorders were included in the analyses. Treatment data were linked to participants' register data on employment, education and acute contact to psychiatric services for the following two years. Multivariable logistic regression models were used to examine associations between the three adverse experiences, NEET and need of acute psychiatric help, adjusting for confounders such as age, gender, ethnicity, treatment response and treatment condition. More than half of the participants were NEET two years after treatment enrolment. After controlling for demographics and treatment conditions, NEET was predicted by parental substance use problems (odds ratio [OR] = 1.89, 95% confidence interval [CI] 1.31- 2.70), exposure to physical abuse (OR = 1.48, 95% CI 1.03-2.13) and non-abstinence (abstinence was negatively associated with NEET, OR = 0.53, 95% CI 0.37-0.76). Being exposed to two (OR = 3.17, 95% CI 1.93-5.21) and three types of adverse experiences (OR = 3.14, 95% CI = 1.47-6.70) predicted NEET more strongly than exposure to one type. One out of 10 participants sought acute care from psychiatric services at least once within two years after treatment. Only sex and ethnic minority status were associated with contacting psychiatric services acutely. The present study suggests that adverse experiences, such as being exposed to parental problematic substance use and physical abuse, may be important predictors for NEET after treatment for SUDs.
本研究前瞻性地考察了在接受物质使用障碍治疗的患者中，不良经历（身体虐待、性虐待和父母物质使用问题[SUPs]）、未就业、未接受教育或培训（NEET）与需要急性精神科帮助之间的关联。共有580名年龄在15至25岁之间接受药物使用障碍治疗的青少年和青年纳入分析。治疗数据与参与者接下来两年的就业、教育登记数据以及与精神科服务的急性接触情况相关联。多变量逻辑回归模型用于检验三种不良经历、NEET与需要急性精神科帮助之间的关联，并对年龄、性别、种族、治疗反应和治疗条件等混杂因素进行调整。超过一半的参与者在治疗登记两年后处于NEET状态。在控制人口统计学和治疗条件后，父母物质使用问题（优势比[OR]=1.89，95%置信区间[CI]1.31 - 2.70）、遭受身体虐待（OR = 1.48，95% CI 1.03 - 2.13）和未戒除（戒除与NEET呈负相关，OR = 0.53，95% CI 0.37 - 0.76）可预测NEET。遭受两种（OR = 3.17，95% CI 1.93 - 5.21）和三种不良经历（OR = 3.14，95% CI = 1.47 - 6.70）比遭受一种不良经历更能强烈预测NEET。十分之一的参与者在治疗后两年内至少有一次寻求精神科服务的急性护理。只有性别和少数族裔身份与急性接触精神科服务相关。本研究表明，诸如接触父母有问题的物质使用和身体虐待等不良经历，可能是物质使用障碍治疗后NEET的重要预测因素。
