Substance misuse and psychiatric illness: prospective observational study using the general practice research database
Substance misuse and psychiatric illness: prospective observational study using the general practice research database
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DOI：
10.1136/jech.2004.030833
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发表时间：
2005-10-01
影响因子：
6.3
通讯作者：
Croft, P
中科院分区：
文献类型：
--
作者：
Frisher, M;Crome, I;Croft, P
目的：为了量化物质滥用和精神疾病之间的关系，在英国的一般做法的人口（a）的相对风险，开发一个条件之前暴露于其他和（B）的比例的情况下，一个条件可归因于暴露于other.Design：人口为基础的前瞻性观察性研究使用的一般做法的研究数据库（GPRD）在1993年和1998年之间。230家全科医生诊所占总人口的3.1%。设置：英格兰和威尔士。参与者：140万名注册患者，其中3969人在1993年至1998年期间有药物滥用和精神病诊断。主要结果测量：相对风险（RR）暴露于药物滥用的参与者随后出现精神疾病，暴露于药物滥用的参与者随后出现药物滥用的RR精神病精神疾病归因于物质滥用和物质滥用归因于psychiatric illness.Results：在研究期间精神疾病的基线患病率为15%和0.3%的物质滥用的人口归因风险（PAR）。物质滥用者与非物质滥用者相比，精神疾病的RR为1.54（95%CI 1.47至1.62）。精神科与非精神科病例相比，物质滥用的RR为2.09（95%CI 1.99至2.22）。精神疾病归因于药物滥用的PAR为0.2%。精神疾病所致物质滥用的PAR为14.2%。讨论：只有相对较小比例的精神疾病似乎可能归因于物质使用，而物质使用的更大比例似乎可能归因于精神疾病。本研究不支持物质滥用和精神疾病之间的共病主要是物质滥用的结果或共病的增加主要归因于物质滥用的假设。
Objectives: To quantify the relation between substance misuse and psychiatric illness in the UK general practice population in terms of (a) the relative risk of developing one condition given prior exposure to the other and (b) the proportion of cases of one condition attributable to exposure to the other.Design: Population based prospective observational study using the general practice research database (GPRD) between 1993 and 1998. The 230 GP practices represent 3.1% of the population.Setting: England and Wales.Participants: 1.4 million registered patients of whom 3969 had both substance misuse and psychiatric diagnoses between 1993 and 1998.Main outcome measures: Relative risk (RR) for subsequent psychiatric illness among participants exposed to substance misuse and RR for subsequent substance misuse among participants exposed to psychiatric illness. Population attributable risk (PAR) of psychiatric illness attributable to substance misuse and of substance misuse attributable to psychiatric illness.Results: The baseline prevalence of psychiatric illness over the study period was 15% and 0.3% for substance abuse. RR for psychiatric illness for substance misusers compared with non- substance misusers was 1.54 (95% CI 1.47 to 1.62). RR for substance misuse among psychiatric compared with nonpsychiatric cases was 2.09 (95% CI 1.99 to 2.22). PAR for psychiatric illness attributable to substance misuse was 0.2%. PAR for substance misuse attributable to psychiatric illness was 14.2%.Discussion: Only a comparatively small proportion of psychiatric illness seems possibly attributable to substance use whereas a more substantial proportion of substance use seems possibly attributable to psychiatric illness. This study does not support the hypotheses that comorbidity between substance misuse and psychiatric illness is primarily the result of substance misuse or that increasing comorbidity is largely attributable to increasing substance misuse.