Lopes C S, Lewis G, Mann A
Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Rua São Francisco Xavier, Brazil.
Soc Psychiatry Psychiatr Epidemiol. 1996 Nov;31(6):355-63. doi: 10.1007/BF00783425.
This study tested the hypothesis that a history of psychiatric and alcohol disorders would affect the risk of developing drug abuse or dependence later in life. This case-control study selected cases and controls using the "snowball" technique in order to obtain cases from this "hidden" population and to match sex, age and friendship. Information was gathered using the Composite International Diagnostic Interview (CIDI), and computer diagnoses were generated according to the DSM-III-R criteria. The study included 370 subjects. Results of the conditional logistic regression analysis showed that having a history of alcohol dependence was independently associated with an increased risk of drug abuse/dependence (OR = 2.6, 95% CI 1.1-6.0) and that this risk was even higher for those whose alcohol dependence occurred in combination with another psychiatric disorder (OR = 4.6, 95% CI 2.1-10.0). An increased risk of drug abuse/dependence was also found for those who were aged 12 years or under when their first psychiatric disorder was manifested (OR = 2.2, 95% CI 1.3-3.7) and among those with two or more psychiatric disorders (OR = 2.5, 95% CI 1.5-4.1). These findings suggest that programmes directed towards the treatment and prevention of drug abuse must be prepared to address psychiatric and alcohol disorders in childhood and adolescence.
精神疾病和酒精紊乱病史会影响日后发生药物滥用或药物依赖的风险。这项病例对照研究采用“滚雪球”技术选取病例和对照，以便从这个“隐匿”人群中获取病例，并匹配性别、年龄和友谊关系。使用复合国际诊断访谈（CIDI）收集信息，并根据《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）标准进行计算机诊断。该研究纳入了370名受试者。条件逻辑回归分析结果显示，有酒精依赖病史与药物滥用/药物依赖风险增加独立相关（比值比[OR]=2.6，95%置信区间[CI]为1.1 - 6.0），而且对于那些酒精依赖与另一种精神疾病并发的人来说，这种风险更高（OR = 4.6，95% CI为2.1 - 10.0）。首次出现精神疾病时年龄在12岁及以下的人（OR = 2.2，95% CI为1.3 - 3.7）以及患有两种或更多种精神疾病的人（OR = 2.5，95% CI为1.5 - 4.1），药物滥用/药物依赖风险也有所增加。这些研究结果表明，针对药物滥用治疗和预防的项目必须准备好应对儿童期和青少年期的精神疾病和酒精紊乱问题。
