Clark D B, Pollock N, Bukstein O G, Mezzich A C, Bromberger J T, Donovan J E
Pittsburgh Adolescent Alcohol Research Center, University of Pittsburgh School of Medicine, PA, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Sep;36(9):1195-203. doi: 10.1097/00004583-199709000-00011.
Although several mental disorders have been shown to be common in adolescents with substance use disorders, prior studies have not specifically focused on alcohol dependence and have not had sufficient sample sizes to examine gender effects. This study contrasts mental disorder diagnoses and symptoms between a sample of adolescents with alcohol dependence and a community control sample of adolescents and incorporates gender analyses.
Adolescents (aged 14 years 0 months to 18 years 0 months) with alcohol dependence (females: n = 55; males: n = 78) and community-dwelling control adolescents without substance use disorders (females: n = 44; males: n = 42) were assessed by means of a semistructured interview for DSM-III-R.
While cannabis and hallucinogen use disorders were common in the alcohol dependence group, females and males had similar rates. Conduct disorder (CD), oppositional defiant disorder, attention-deficit hyperactivity disorder, major depression (MD), and posttraumatic stress disorder (PTSD) had significantly higher rates in the alcohol dependence than in the community control group. Depression and PTSD symptoms were more strongly associated with alcohol dependence in females than in males. A configural frequency analysis showed that CD and MD tended to occur together in both female and male adolescents with alcohol dependence.
While alcohol-dependent females and males similarly exhibited more comorbid disorders than control adolescents, gender affects the relationship of alcohol dependence to MD and PTSD. Rather than reflecting distinct types, the comorbid disorders of CD and MD jointly characterize many adolescents with alcohol dependence.
尽管已表明几种精神障碍在患有物质使用障碍的青少年中很常见,但先前的研究并未专门聚焦于酒精依赖,且样本量不足以检验性别差异。本研究对比了酒精依赖青少年样本与社区青少年对照样本的精神障碍诊断及症状,并纳入了性别分析。
通过针对《精神疾病诊断与统计手册第三版修订版》(DSM-III-R)的半结构化访谈,对患有酒精依赖的青少年(年龄14岁0个月至18岁0个月,女性:n = 55;男性:n = 78)以及无物质使用障碍的社区居住对照青少年(女性:n = 44;男性:n = 42)进行评估。
虽然大麻和致幻剂使用障碍在酒精依赖组中很常见,但女性和男性的发生率相似。品行障碍(CD)、对立违抗障碍、注意力缺陷多动障碍、重度抑郁症(MD)和创伤后应激障碍(PTSD)在酒精依赖组中的发生率显著高于社区对照组。与男性相比,抑郁症和PTSD症状在女性酒精依赖者中与酒精依赖的关联更强。构型频率分析表明,在患有酒精依赖的女性和男性青少年中,CD和MD往往同时出现。
虽然酒精依赖的女性和男性与对照青少年相比同样表现出更多的共病障碍,但性别会影响酒精依赖与MD和PTSD之间的关系。CD和MD的共病障碍并非反映不同类型,而是共同刻画了许多酒精依赖青少年的特征。