Brook J S, Cohen P, Brook D W
Department of Community Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
J Am Acad Child Adolesc Psychiatry. 1998 Mar;37(3):322-30. doi: 10.1097/00004583-199803000-00018.
To examine temporal priority in the relationship between psychiatric disorders and drug use.
Psychiatric assessments and drug use were completed at three different points in time, spanning 9 years. Structured interviews were administered to a cohort of youths and their mothers. Subjects were selected on the basis of their residence in either of two counties in upstate New York. The sample was predominantly white male and female youths, aged 1 through 10 years upon initial collection of data. Psychiatric diagnoses were assessed by a supplemented version of the Diagnostic Interview Schedule for Children Version 1, using computer algorithms designed to match DSM-III-R criteria to combine information from mothers and youths. Substance use information was obtained in the interviews.
A significant relationship was found to exist between earlier adolescent drug use and later depressive and disruptive disorders in young adulthood, controlling for earlier psychiatric disorders. Earlier psychiatric disorders did not predict changes in young adult drug use.
Implications for policy, prevention, and treatment include (1) more medical attention needs to be given to the use of legal and illegal drugs; and (2) a decrease in drug use may result in a decrease in the incidence of later psychiatric disorders.
研究精神疾病与药物使用之间关系中的时间先后顺序。
在9年的时间里，于三个不同时间点完成了精神状况评估和药物使用情况调查。对一组青少年及其母亲进行了结构化访谈。根据他们居住在纽约州北部两个县中的一个来选取研究对象。样本主要是年龄在1至10岁之间的白人青少年男女，数据首次收集时他们处于该年龄段。使用旨在将《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）标准与来自母亲和青少年的信息相结合的计算机算法，通过儿童诊断访谈表第1版的补充版本对精神疾病进行诊断。在访谈中获取药物使用信息。
在控制早期精神疾病的情况下，发现青少年早期药物使用与成年早期后期的抑郁和行为障碍之间存在显著关系。早期精神疾病并不能预测成年后药物使用情况的变化。
对政策、预防和治疗的启示包括：（1）需要对合法和非法药物的使用给予更多医疗关注；（2）药物使用的减少可能会导致后期精神疾病发病率的降低。
