Substance use in individuals at clinical high risk of psychosis.
Substance use in individuals at clinical high risk of psychosis.
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DOI：
10.1017/s0033291715000227
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发表时间：
2015-08
影响因子：
6.9
通讯作者：
Addington J
中科院分区：
文献类型：
--
作者：
Buchy L;Cadenhead KS;Cannon TD;Cornblatt BA;McGlashan TH;Perkins DO;Seidman LJ;Tsuang MT;Walker EF;Woods SW;Heinssen R;Bearden CE;Mathalon D;Addington J
一系列研究报告表明，在临床上有患精神病高风险的青年中，大麻、酒精和烟草等物质的使用率高于对照组。人们对物质使用的纵向轨迹知之甚少，关于物质使用与精神病患者后来过渡到精神病之间关系的研究结果喜忧参半。在基线以及6个月和12个月的随访中，735名CHR参与者和278名对照参与者完成了酒精和药物使用量表以及大麻使用问卷。物质使用的纵向轨迹进行了评估与线性混合模型。与对照组相比，研究参与者在基线和1年内支持大麻和烟草使用严重程度显着较高，酒精使用严重程度较低。青年人一生中使用大麻的流行率和频率较高，首次使用时明显较年轻，更有可能单独使用和在白天使用。基线物质使用没有区分后来转变为精神病的参与者（n = 90）和没有转变的参与者（n = 272）。在2年评估中，对照组的烟草使用率低于具有前驱进展临床结局的研究参与者，大麻使用率低于具有精神病临床结局的研究参与者。在100万人中，大麻和烟草的使用高于对照组，这种模式持续了一年。临床结局的评价可以提供关于物质使用的纵向影响的额外信息，这些信息无法通过单独评价向精神病的转变/非转变来检测。
A series of research reports has indicated that the use of substances such as cannabis, alcohol and tobacco are higher in youth at clinical high risk (CHR) of developing psychosis than in controls. Little is known about the longitudinal trajectory of substance use, and findings on the relationship between substance use and later transition to psychosis in CHR individuals are mixed. At baseline and 6- and 12-month follow-ups, 735 CHR and 278 control participants completed the Alcohol and Drug Use Scale and a cannabis use questionnaire. The longitudinal trajectory of substance use was evaluated with linear mixed models. CHR participants endorsed significantly higher cannabis and tobacco use severity, and lower alcohol use severity, at baseline and over a 1-year period compared with controls. CHR youth had higher lifetime prevalence and frequency of cannabis, and were significantly younger upon first use, and were more likely to use alone and during the day. Baseline substance use did not differentiate participants who later transitioned to psychosis (n = 90) from those who did not transition (n = 272). Controls had lower tobacco use than CHR participants with a prodromal progression clinical outcome and lower cannabis use than those with a psychotic clinical outcome at the 2-year assessment. In CHR individuals cannabis and tobacco use is higher than in controls and this pattern persists across 1 year. Evaluation of clinical outcome may provide additional information on the longitudinal impact of substance use that cannot be detected through evaluation of transition/non-transition to psychosis alone.