Kovačić Petrović Zrnka, Peraica Tina, Blažev Mirta, Kozarić-Kovačić Dragica
Department of Psychiatry and Psychological Medicine, University of Zagreb School of Medicine, Zagreb, Croatia.
Department of Addiction, University Hospital Vrapče, Zagreb, Croatia.
Front Psychiatry. 2024 Feb 29;15:1295977. doi: 10.3389/fpsyt.2024.1295977. eCollection 2024.
The prolonged stress experience caused by the COVID-19 pandemic and two earthquakes led to increased alcohol and psychoactive substance use (PSU) accompanied by a decrease in mental wellbeing and quality of life (QoL) in the Croatian population. Our aim was to determine the relationship between alcohol and PSU and mental health outcomes including anxiety and depression, and QoL.
A cross-sectional online survey conducted from September 30 to October 27, 2021, included 1,118 Croatian adults (220 men and 898 women; mean age, 35.1 ± 12.3 years) recruited through non-probabilistic convenience sampling. The survey consisted of a self-reported questionnaire on PSU, the CAGE Alcohol Questionnaire, the Hospital Anxiety Depression Scale, and the World Health Organization Quality of Life (WHOQoL)-BREF. Structural equation modeling was used to evaluate the association between PSU, problematic alcohol use (PAU), mental health outcomes, and QoL.
The model demonstrated a good fit and indicated that PSU increase, PAU, and anxiety and depression symptoms significantly explained all QoL domains ( < 0.001 for all). Both PSU increase and PAU during prolonged stress were directly associated with decreased QoL. These relationships were also indirectly mediated through increased anxiety and depression symptoms.
These results showed the need to direct public health interventions and treatment interventions during and after long-term stress (pandemics and earthquakes) to reduce the negative impact on substance use and QoL by reducing depression and anxiety, which ultimately may contribute to better wellbeing and rapid recovery of individuals affected by prolonged stress.
由新冠疫情和两次地震所引发的长期压力体验，导致克罗地亚人群中酒精和精神活性物质使用（PSU）增加，同时心理健康和生活质量（QoL）下降。我们的目的是确定酒精和PSU与包括焦虑和抑郁在内的心理健康结果以及生活质量之间的关系。
于2021年9月30日至10月27日进行的一项横断面在线调查，纳入了1118名克罗地亚成年人（220名男性和898名女性；平均年龄35.1±12.3岁），通过非概率便利抽样招募。该调查包括一份关于PSU的自我报告问卷、CAGE酒精问卷、医院焦虑抑郁量表以及世界卫生组织生活质量（WHOQoL）-BREF。采用结构方程模型来评估PSU、问题性酒精使用（PAU）、心理健康结果和生活质量之间的关联。
该模型显示拟合良好，并表明PSU增加、PAU以及焦虑和抑郁症状显著解释了所有生活质量领域（所有均P<0.001）。长期压力期间PSU增加和PAU均与生活质量下降直接相关。这些关系还通过焦虑和抑郁症状增加而间接介导。
这些结果表明，在长期压力（疫情和地震）期间及之后，需要开展公共卫生干预和治疗干预，以通过减轻抑郁和焦虑来减少对物质使用和生活质量的负面影响，这最终可能有助于受长期压力影响的个体获得更好的幸福感并快速康复。
