Nunes E V, Weissman M M, Goldstein R B, McAvay G, Seracini A M, Verdeli H, Wickramaratne P J
Department of Genetic Epidemiology, New York State Psychiatric Institute, NY 10032, USA.
J Am Acad Child Adolesc Psychiatry. 1998 Nov;37(11):1142-51. doi: 10.1097/00004583-199811000-00013.
To evaluate psychiatric disorders and impairment in school-age and adolescent children of opiate-dependent patients.
One hundred fourteen children, aged 6 to 17 years, of 69 white methadone maintenance patients with (n = 30) and without (n = 39) major depression were evaluated for DSM-III-R diagnoses by the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic version and best estimate, and by measures of functioning (Children's Global Assessment Scale, Social Adjustment Inventory for Children and Adolescents, WISC, Peabody Picture Vocabulary Test), and compared with children of historical controls without substance abuse history.
Sons of opiate addicts with major depression were at increased risk for conduct disorder and global, social, and intellectual impairment compared with sons of opiate addicts without major depression and/or sons of controls with neither drug dependence nor depression. Sons of opiate addicts without major depression differed little from controls. Daughters of opiate addicts did not differ from controls in rates of disorders but had poorer social adjustment and nonverbal intelligence.
Children of opiate-dependent patients, particularly sons of addicts with depression, may be at risk for a developmental path toward antisocial personality and poor social and intellectual functioning. Treatment settings such as methadone maintenance might afford an opportunity for primary and secondary prevention, both through early detection of childhood disorders and treatment of parental drug dependence and psychopathology.
评估阿片类药物依赖患者的学龄期及青少年子女的精神障碍及功能损害情况。
采用儿童情感障碍及精神分裂症量表-流行病学版及最佳估计法，对69名接受美沙酮维持治疗的白人患者的114名6至17岁子女进行DSM-III-R诊断评估，其中30名患者患有重度抑郁症，39名患者未患重度抑郁症。同时采用功能测量方法（儿童总体评估量表、儿童及青少年社会适应量表、韦氏儿童智力量表、皮博迪图片词汇测验），并与无药物滥用史的历史对照儿童进行比较。
与无重度抑郁症的阿片类药物成瘾者的儿子和/或既无药物依赖也无抑郁症的对照组儿子相比，患有重度抑郁症的阿片类药物成瘾者的儿子患品行障碍以及出现整体、社交和智力功能损害的风险更高。无重度抑郁症的阿片类药物成瘾者的儿子与对照组差异不大。阿片类药物成瘾者的女儿在精神障碍发生率上与对照组无差异，但社会适应和非言语智力较差。
阿片类药物依赖患者的子女，尤其是患有抑郁症的成瘾者的儿子，可能面临发展为反社会人格以及社会和智力功能较差的风险。美沙酮维持治疗等治疗环境可能提供一级和二级预防的机会，包括早期发现儿童期疾病以及治疗父母的药物依赖和精神病理学问题。
