Transitions from first substance use to substance use disorders in adolescence: Is early onset associated with a rapid escalation?
Transitions from first substance use to substance use disorders in adolescence: Is early onset associated with a rapid escalation?
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DOI：
10.1016/j.drugalcdep.2008.06.014
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发表时间：
2009-01-01
影响因子：
4.2
通讯作者：
Beesdo, K.
中科院分区：
文献类型：
--
作者：
Behrendt, S.;Wittchen, H. -U.;Beesdo, K.
背景：已知青少年早期物质使用（SU）与物质使用障碍（SUD）的风险升高有关；然而，尚不清楚早期SU是否与更快地转变为SUD有关。目的：探讨首次使用SU（酒精、尼古丁、大麻）向SUD过渡的风险和速度与首次使用年龄的关系。方法：对3021名14-24岁的社区受试者进行10年的前瞻性随访。SU和SUD采用DSM-IV/M-CTDI进行评估。结果：(1)物质特异性SU-SUD过渡的条件概率以尼古丁最高（36.0%），大麻最低（滥用18.3%，依赖6.2%），酒精介于两者之间（滥用25.3%，依赖11.2%）。(2)除了证实早期SU是SUD的危险因素外，我们还发现：(3)除了大麻依赖外，我的SU发病年龄越高，向SUD过渡的速度越快。(4)从首次使用大麻（CU）过渡到大麻使用障碍（CUD）的发生速度快于酒精和尼古丁。(5)与向特定sud过渡的风险和速度同时发生的其他物质的使用。结论：药物类型和同时使用其他药物对首次使用年龄和过渡到药物使用障碍的速度有重要影响。鉴于进一步的研究将确定影响这些差异关联的调节因子和介质，这些发现可能对设计早期和有针对性的干预措施以预防疾病进展具有重要意义。2008爱思唯尔爱尔兰有限公司版权所有。
Background: Early substance use (SU) in adolescence is known to be associated with an elevated risk of developing substance use disorders (SUD); it remains unclear though whether early SU is associated with more rapid transitions to SUD.Objective: To examine the risk and speed of transition from first SU (alcohol, nicotine, cannabis) to SUD as a function of age of first use.Methods: N=3021 community subjects aged 14-24 years at baseline were followed-up prospectively over 10-years. SU and SUD were assessed using the DSM-IV/M-CTDI.Results: (1) The conditional probability of substance-specific SU-SUD transition was the greatest for nicotine (36.0%) and the least for cannabis (18.3% for abuse, 6.2% for dependence) with alcohol in between (25.3% for abuse: 11.2% for dependence). (2) In addition to confirming early SU as a risk factor for SUD we find: (3) higher age of onset of my SU to be associated with faster transitions to SUD, except for cannabis dependence. (4) Transitions from first cannabis use (CU) to cannabis use disorders (CUD) Occurred faster than for alcohol and nicotine. (5) Use of other substances co-occured with risk and speed of transitions to specific SUDs.Conclusion: Type of Substance and concurrent use of other drugs are of importance for the association between age of first use and the speed of transitions to substance use disorders. Given that further research will identify moderators and mediators affecting these differential associations, these findings may have important implications for designing early and targeted interventions to prevent disorder progression. (c) 2008 Elsevier Ireland Ltd. All rights reserved.