Does methamphetamine use increase violent behaviour? Evidence from a prospective longitudinal study
Does methamphetamine use increase violent behaviour? Evidence from a prospective longitudinal study
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DOI：
10.1111/add.12474
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发表时间：
2014-05-01
期刊：
影响因子：
6
通讯作者：
Baker, Amanda L.
中科院分区：
文献类型：
--
作者：
McKetin, Rebecca;Lubman, Dan I.;Baker, Amanda L.
目的确定甲基苯丙胺使用期间暴力行为是否增加，以及这是否是由于甲基苯丙胺诱发的精神病症状所致。设计了一项纵向前瞻性队列研究，对四个非连续的 1 个月观察期进行固定效应（受试者内）分析。设置澳大利亚悉尼和布里斯班。参与者共有 278 名年龄在 16 岁或以上、符合 DSM-IV 甲基苯丙胺依赖标准的参与者参加该研究，但不符合 DSM-IV 终生精神分裂症或躁狂症标准的人。 测量 暴力行为被定义为过去一个月中简明精神病评定量表 (BPRS) 中的严重敌意（对应于攻击/损坏财产）。使用阿片治疗指数评估过去一个月甲基苯丙胺和其他物质使用的天数。使用 BPRS 识别出过去一个月的阳性精神病症状。结果在调整其他物质使用和社会人口统计数据后，与未使用甲基苯丙胺时相比，个体使用甲基苯丙胺时的暴力行为出现剂量相关的增加[参见 2017 年]。过去一个月没有使用：1-15天使用优势比（OR）=2.8，95%置信区间（CI）=1.6-4.9；使用 16 天以上 OR = 9.5，95% CI = 4.8-19.1]。精神病症状进一步增加了暴力行为的几率（OR = 2.0，95% CI = 1.1-3.6），占与甲基苯丙胺使用相关的暴力行为的 22-30%。大量饮酒还会增加暴力行为的风险（OR = 3.1，95% CI = 1.4-7.0），占与甲基苯丙胺使用相关的暴力风险的 12-18%。 结论 在甲基苯丙胺使用期间，暴力行为的增加与剂量相关，这在很大程度上与精神病症状相关的暴力风险无关。
AimsTo determine whether violent behaviour increases during periods of methamphetamine use and whether this is due to methamphetamine-induced psychotic symptoms.DesignA fixed-effects (within-subject) analysis of four non-contiguous 1-month observation periods from a longitudinal prospective cohort study.SettingSydney and Brisbane, Australia.ParticipantsA total of 278 participants aged 16 years or older who met DSM-IV criteria for methamphetamine dependence on entry to the study but who did not meet DSM-IV criteria for life-time schizophrenia or mania.MeasurementsViolent behaviour was defined as severe hostility in the past month on the Brief Psychiatric Rating Scale (BPRS) (corresponding to assault/damage to property). Days of methamphetamine and other substance use in the past month were assessed using the Opiate Treatment Index. Positive psychotic symptoms in the past month were identified using the BPRS.FindingsThere was a dose-related increase in violent behaviour when an individual was using methamphetamine compared with when they were not after adjusting for other substance use and socio-demographics [cf. no use in the past month: 1-15 days of use odds ratio (OR) = 2.8, 95% confidence interval (CI) =1.6-4.9; 16+ days of use OR = 9.5, 95% CI = 4.8-19.1]. The odds of violent behaviour were further increased by psychotic symptoms (OR = 2.0, 95% CI = 1.1-3.6), which accounted for 22-30% of violent behaviour related to methamphetamine use. Heavy alcohol consumption also increased the risk of violent behaviour (OR = 3.1, 95% CI = 1.4-7.0) and accounted for 12-18% of the violence risk related to methamphetamine use.ConclusionsThere is a dose-related increase in violent behaviour during periods of methamphetamine use that is largely independent of the violence risk associated with psychotic symptoms.