Emergence of sex differences in the development of substance use and abuse during adolescence.
Emergence of sex differences in the development of substance use and abuse during adolescence.
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DOI：
10.1016/j.pharmthera.2015.06.003
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发表时间：
2015-09
影响因子：
13.5
通讯作者：
Kuhn C
中科院分区：
文献类型：
--
作者：
Kuhn C
药物使用和滥用始于青春期。男性和女性青春期人类开始使用的速度相当，但男性增加使用的速度更快。在成年阶段，使用和滥用成瘾药物的男性比女性多。然而，一些妇女从开始使用到进入治疗进展更快。在动物模型中，青少年男性和女性服用令人上瘾的药物是相似的。然而，生殖能力成熟的女性获得自我管理的速度更快，在某些型号中，使用更多。性别/性别差异存在于神经生物因素(多巴胺、阿片类药物)和厌恶感(CRF、强啡肽)，以及影响从最初使用到滥用的内在因素(个性、精神疾病共病)和外在因素(虐待史、环境，尤其是同伴和家庭)。许多这些重要的差异出现在青春期，并被大脑的性别分化所缓和。雌二醇效应增强了多巴胺能和促肾上腺皮质激素释放激素介导的过程，使女性更容易受到药物使用和滥用的影响。睾丸素增强了男性和女性的冲动和寻求感觉的能力。女性中的几个保护性因素也影响物质使用的开始和进展，包括怀孕期间的荷尔蒙变化以及更强的自我调节能力和更低的冲动/感觉寻求峰值水平。在青春期，同性同龄人对男性的风险比对女性更大，而在这个发育时期，浪漫伴侣会增加女性的风险。总而言之，随着青少年开始开始使用药物，生物因素、精神疾病的共病以及个性和环境呈现出性别/性别特有的风险。
Substance use and abuse begins during adolescence. Male and female adolescent humans initiate use at comparable rates, but males increase use faster. In adulthood, more men than women use and abuse addictive drugs. However, some women progress more rapidly from initiation of use to entry into treatment. In animal models, adolescent males and females consume addictive drugs similarly. However, reproductively mature females acquire self-administration faster, and in some models, escalate use more. Sex/gender differences exist in neurobiologic factors mediating both reinforcement (dopamine, opioids) and aversiveness (CRF, dynorphin), as well as intrinsic factors (personality, psychiatric co-morbidities) and extrinsic factors (history of abuse, environment especially peers and family) which influence the progression from initial use to abuse., Many of these important differences emerge during adolescence, and are moderated by sexual differentiation of the brain. Estradiol effects which enhance both dopaminergic and CRF-mediated processes contribute to the female vulnerability to substance use and abuse. Testosterone enhances impulsivity and sensation seeking in both males and females. Several protective factors in females also influence initiation and progression of substance use including hormonal changes of pregnancy as well as greater capacity for self-regulation and lower peak levels of impulsivity/sensation seeking. Same sex peers represent a risk factor more for males than females during adolescence, while romantic partners increase risk for women during this developmental epoch. In summary, biologic factors, psychiatric co-morbidities as well as personality and environment present sex/gender-specific risks as adolescents begin to initiate substance use.