Clinical importance of caffeine dependence and abuse
Clinical importance of caffeine dependence and abuse
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DOI：
10.1111/j.1440-1819.2007.01652.x
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发表时间：
2007-06-01
影响因子：
11.9
通讯作者：
Ueki, Hirofumi
中科院分区：
文献类型：
--
作者：
Ogawa, Naoshi;Ueki, Hirofumi
咖啡因是最广泛使用的精神活性物质，是一种合法的兴奋剂，儿童可以随时获得。咖啡因有时被认为是一种滥用药物，对咖啡因的依赖性也一直存在争议。目前，由于缺乏咖啡因依赖或滥用的临床证据，《精神障碍诊断与统计手册》第四版中没有这样的诊断。作者提出了两个滥用或依赖“富营养化”（能量/营养）饮料或咖啡因制剂中所含咖啡因的案例，随后对临床研究进行了回顾，证明了一些人可能表现出咖啡因依赖或滥用的临床综合征。这些案例表明，咖啡因会产生一种临床依赖综合症，类似于其他精神活性物质产生的症状，并有滥用的可能。在最近的一项研究中，使用结构化访谈和精神障碍诊断与统计手册-第四版物质依赖和滥用标准，发现普通人群中的一部分人表现出咖啡因依赖或咖啡因滥用。因此，作者建议，生产或销售咖啡因或含咖啡因产品的公司或企业必须遵守以下准则：(i)明确指出咖啡因含量相对较高的产品的咖啡因含量；（ii）警告婴儿和儿童尽可能避免食用此类产品，并告知成年消费者可安全食用的确切咖啡因量；（三）明确指出，摄入大量咖啡因和长期使用咖啡因会带来健康风险。
Caffeine is the most widely consumed psychoactive substance and is a legal stimulant that is readily available to children. Caffeine has occasionally been considered a drug of abuse and the potential for dependence on caffeine has been debated. Presently, due to a paucity of clinical evidence on caffeine dependence or abuse, no such diagnosis is included in the Diagnostic and Statistical Manual of Mental Disorder-fourth edition. The authors present two cases of abuse or dependence on the caffeine contained in 'eutrophic' (energy/nutritional) beverages or caffeine preparations, followed by a review of clinical studies demonstrating evidence that some people can manifest a clinical syndrome of caffeine dependence or abuse. The cases suggest that caffeine can produce a clinical dependence syndrome similar to those produced by other psychoactive substances and has a potential for abuse. In a recent study using a structured interview and the Diagnostic and Statistical Manual of Mental Disorder-fourth edition criteria for substance dependence and abuse, a subset of the general population was found to demonstrate caffeine dependence or caffeine abuse. Therefore, the authors propose that companies or businesses manufacturing or marketing caffeine or products containing caffeine must meet the following guidelines: (i) clearly indicate the caffeine content of products containing comparatively higher quantities of caffeine; (ii) warn that such products should be avoided by infants and children wherever possible, and inform adult consumers about the precise quantity of caffeine that is considered safe for consumption; and (iii) clearly state that consuming large quantities of caffeine and the long-term use of caffeine carry health risks.