Comorbid trajectories of substance use as predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder
Comorbid trajectories of substance use as predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder
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DOI：
10.1016/j.addbeh.2016.06.003
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发表时间：
2016-11-01
影响因子：
4.4
通讯作者：
Brook, David W.
中科院分区：
文献类型：
--
作者：
Brook, Judith S.;Zhang, Chenshu;Brook, David W.
目的：确定成年期共病吸烟、饮酒和大麻使用模式与反社会人格障碍 (ASPD)、重度抑郁发作 (MDE) 和广泛性焦虑症 (GAD) 之间的纵向关联。方法：来自社区儿童和成人研究的随机社区样本 [(X) 超过酒吧年龄 = 36.6 (SD = 2.8)]，该研究是一项关于物质使用和滥用的持续调查。精神疾病。在六个时间波收集数据。确定了从青春期到成年期间吸烟、饮酒和大麻使用的联合轨迹；多变量逻辑回归分析评估了轨迹组成员身份与成年后患有 ASPD、MDE 或 GAD 之间的关联。结果：获得了 5 个联合轨迹组：HHH（长期吸烟、饮酒和大麻使用）、DDD（延迟/晚开始吸烟、酒精和大麻使用）、LML（低/不吸烟、中度饮酒、偶尔使用大麻）、HMN（慢性吸烟、中度饮酒、无吸烟）使用大麻）和不使用（仅偶尔饮酒）。与 NON 组成员相比，HHH 组患者出现 ASPD（调整优势比 [AOR] = 28.52，95% 置信区间 [CI] = 9.44-86.17）、MDE（AOR = 2.67，95% CI = 1.14-6.26）和 GAD（AOR = 6.39， 95% CI = 2.62-15.56）。 DDD、LML 和 HMN 组的成员与三种精神疾病结果的关联较弱且不太一致。结论：在基于社区的大型样本中，长期同时使用一种以上物质与成年后的外化和内化精神疾病相关。预防和治疗计划可能针对社区中的个人和患有药物滥用的一般临床人群，即使他们尚未被确定患有药物滥用障碍。 (C) 2016 Elsevier Ltd. 保留所有权利。
Objective: To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood.Method: A random community-based sample [(X) over bar age = 36.6 (SD = 2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood.Results: Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR] = 28.52, 95% Confidence Interval [CI] = 9.44-86.17), MDE (AOR = 2.67, 95% CI = 1.14-6.26), and GAD (AOR = 6.39, 95% CI = 2.62-15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes.Conclusions: In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven't been identified as having a substance use disorder. (C) 2016 Elsevier Ltd. All rights reserved.