Childhood and adolescent onset psychiatric disorders, substance use, and failure to graduate high school on time
Childhood and adolescent onset psychiatric disorders, substance use, and failure to graduate high school on time
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DOI：
10.1016/j.jpsychires.2010.06.014
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发表时间：
2011-03-01
影响因子：
4.8
通讯作者：
Schweitzer, Julie B.
中科院分区：
文献类型：
--
作者：
Breslau, Joshua;Miller, Elizabeth;Schweitzer, Julie B.
我们研究了儿童期和青少年期发病的精神疾病及物质使用障碍对未能按时从高中毕业的联合预测作用。对美国全国成年人样本（18岁及以上）进行了结构化诊断访谈。分析样本包括至少接受过8年教育、出生在美国或13岁前到达美国的受访者（N = 29662）。将精神疾病、物质使用及物质使用障碍作为高中毕业前教育进程终止或中断的预测因素进行研究，并对人口统计学特征和童年逆境进行统计调整。在接受研究的任何精神疾病和物质使用障碍的受访者中，未能按时从高中毕业的情况更为常见，比例从18.1%（特定恐惧症）到33.2%（注意力缺陷多动障碍 - 混合型）不等，而无疾病的受访者中该比例为15.2%。在对共病障碍进行调整后，仅品行障碍（优势比 = 1.89，95%置信区间1.57 - 2.26）和三种注意力缺陷多动障碍亚型（注意力不集中型优势比 = 1.78，95%置信区间1.44 - 2.20；多动冲动型优势比 = 1.38，95%置信区间1.14 - 1.67；混合型优势比 = 2.06，95%置信区间1.66 - 2.56）与未能按时毕业仍存在显著关联。在对先前的疾病进行调整后，吸烟与未能按时毕业有关（优势比 = 1.97，95%置信区间1.80 - 2.16）。在物质使用者中，物质使用障碍与按时毕业无关。研究结果表明，儿童期和青少年期发病的精神疾病对高中毕业的不利影响在很大程度上是由品行和注意力不集中问题造成的。在对这些障碍进行调整后，吸烟仍然与未能按时从高中毕业密切相关。（C）2010爱思唯尔有限公司。保留所有权利。
We examined the joint predictive effects of childhood and adolescent onset psychiatric and substance use disorders on failure to graduate high school (HS) on time. Structured diagnostic interviews were conducted with a US national sample of adults (18 and over). The analysis sample included respondents with at least 8 years of education who were born in the US or arrived in the US prior to age 13 (N = 29,662). Psychiatric disorders, substance use and substance use disorders were examined as predictors of termination or interruption of educational progress prior to HS graduation, with statistical adjustment for demographic characteristics and childhood adversities. Failure to graduate HS on time was more common among respondents with any of the psychiatric and substance use disorders examined, ranging from 18.1% (specific phobia) to 33.2% (ADHD-combined type), compared with respondents with no disorder (15.2%). After adjustment for co-occurring disorders, significant associations with failure to graduate on time remained only for conduct disorder (OR = 1.89, 95% CI 1.57-2.26) and the three ADHD subtypes (Inattentive OR = 1.78, 95% CI 1.44-2.20, Hyperactive Impulsive OR = 1.38, 95% CI 1.14-1.67, and Combined OR = 2.06, 95% CI 1.66-2.56). Adjusting for prior disorders, tobacco use was associated with failure to graduate on time (OR = 1.97, 95% CI 1.80-2.16). Among substance users, substance use disorders were not associated with on-time graduation. The findings suggest that the adverse impact of childhood and adolescent onset psychiatric disorders on HS graduation is largely accounted for by problems of conduct and inattention. Adjusting for these disorders, smoking remains strongly associated with failure to graduate HS on time. (C) 2010 Elsevier Ltd. All rights reserved.