Ramírez Maite, Ugedo Asier, Fañanás Lourdes, Cano-Escalera Guilermo, Saiz Pilar A, Zorrilla Iñaki, González-Pinto Ana
Department of Psychiatry, IIS BIOBIZKAIA, University of the Basque Country (EHU), CIBERSAM, Hospital Universitario Galdakao-Usansolo, Galdakao, Spain.
Department of Psychiatry, Hospital Universitario Galdakao-Usansolo, Galdakao, Spain.
Front Psychiatry. 2025 Jun 18;16:1612494. doi: 10.3389/fpsyt.2025.1612494. eCollection 2025.
Substance use in children and adolescents exposed to childhood adversity is a recognized risk factor for adverse outcomes in mental and physical health. However, few studies focus on the specific mechanisms that lead to it, assuming they are similar to those in adults. The purpose of this review is to explore the existing literature regarding etiological pathways between environmental adversities in childhood and early-onset substance use.
a scoping review was conducted following PRISMA-ScR criteria, as the evidence is complex, heterogeneous, and relatively underexplored. Two independent reviewers searched Medline, Embase, PsycInfo, Web of Science, and grey literature individually for review studies on biological and psychosocial pathways that lead from childhood adversity to early onset substance. Only outcomes that applied to children and adolescents under 18 years were recorded.
Pathways that lead from childhood adversity to early-onset substance use appear to be multifactorial and non-linear. Stress induces changes in vulnerable neural circuits, affecting emotion regulation, decision-making, and intrapersonal and interpersonal functioning. These changes and additional drug-induced effects on the developing brain provoke a cascade of events that increase the risk of heavy and uncontrollable use.
Developmental stage-specific factors may influence substance use in adolescents exposed to childhood adversity. Identifying mediators in this high-risk population is crucial to implementing efficacious preventive strategies.
童年期遭遇逆境的儿童和青少年使用物质是心理健康和身体健康不良后果的一个公认风险因素。然而，很少有研究关注导致这种情况的具体机制，认为它们与成年人的机制相似。本综述的目的是探讨关于童年环境逆境与早发性物质使用之间病因途径的现有文献。
由于证据复杂、异质性强且研究相对不足，按照PRISMA - ScR标准进行了一项范围综述。两名独立评审员分别在Medline、Embase、PsycInfo、Web of Science和灰色文献中搜索关于从童年逆境到早发性物质使用的生物和心理社会途径的综述研究。仅记录适用于18岁以下儿童和青少年的结果。
从童年逆境到早发性物质使用的途径似乎是多因素且非线性的。压力会引起脆弱神经回路的变化，影响情绪调节、决策以及人际和个人功能。这些变化以及药物对发育中大脑的额外影响引发了一系列事件，增加了大量且无法控制使用物质的风险。
特定发育阶段的因素可能会影响童年期遭遇逆境的青少年的物质使用。在这一高风险人群中确定中介因素对于实施有效的预防策略至关重要。
