Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions
Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions
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DOI：
10.1016/j.jad.2008.10.003
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发表时间：
2009-06-01
影响因子：
6.6
通讯作者：
Sareen, Jitender
中科院分区：
文献类型：
--
作者：
Bolton, James M.;Robinson, Jennifer;Sareen, Jitender
背景资料：使用酒精或药物来减少情绪困扰（自我药疗）已被提出作为焦虑和物质使用障碍之间高共患病率的解释。自我药疗已被最低限度地研究情绪disorders.Methods，尽管同样高的酒精和药物的使用率：数据来自全国流行病学调查酒精和相关条件（NESARC），一个大的（n=43,093，年龄18岁及以上）全国代表性的调查精神疾病在社区居住的成年人。自我药疗的患病率被确定为DSM-IV心境障碍：恶劣心境障碍、重性抑郁障碍、双相I型障碍和双相II型障碍。多元Logistic回归产生的优势比之间的关联每一类自我药疗和焦虑和人格disorders.Results：几乎四分之一的个人情绪障碍（24.1%）使用酒精或药物来缓解症状。自我药疗的最高流行率见于双相I型障碍（41.0%）。男性进行自我药疗的可能性是女性的两倍多（调整后的比值比=2.18; 95%置信区间1.90-2.49）。控制物质使用障碍的影响后，自我药疗与高几率的共病焦虑和人格障碍相比，个人谁没有self-self-self-self-cartagedesign. Conclusions：使用酒精和药物来缓解情感症状是常见的个人情绪障碍在一般人群中，但与大量的精神共病。这些发现可能有助于临床医生识别患有情绪障碍、精神疾病负担更高的人群。(C)2008 Elsevier B. V.保留所有权利。
Background: Using alcohol or drugs to reduce emotional distress (self-medication) has been proposed as an explanation for the high comorbidity rates between anxiety and substance use disorders. Self-medication has been minimally studied in mood disorders despite equally high rates of alcohol and drug use.Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a large (n=43,093, age 18 years and older) nationally representative survey of mental illness in community-dwelling adults. Prevalence rates of self-medication were determined for DSM-IV mood disorders: dysthymia, major depressive disorder, bipolar I disorder, and bipolar II disorder. Multiple logistic regression generated odds ratios for the association between each category of self-medication and anxiety and personality disorders.Results: Almost one-quarter of individuals with mood disorders (24.1%) used alcohol or drugs to relieve symptoms. The highest prevalence of self-medication was seen in bipolar I disorder (41.0%). Men were more than twice as likely as women to engage in self-medication (Adjusted Odds Ratio=2.18; 95% Confidence Interval 1.90-2.49). After controlling for the effects of substance use disorders, self-medication was associated with higher odds of comorbid anxiety and personality disorders when compared to individuals who did not self-medicate.Limitations: Cross-sectional design.Conclusions: The use of alcohol and drugs to relieve affective symptoms is common among individuals with mood disorders in the general population, yet is associated with substantial psychiatric comorbidity. These findings may help clinicians identify a subgroup of people with mood disorders who suffer from a higher mental illness burden. (C) 2008 Elsevier B.V. All rights reserved.