Assessing cannabis dependence in community surveys: methodological issues
Assessing cannabis dependence in community surveys: methodological issues
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DOI：
10.1002/mpr.206
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发表时间：
2007-01-01
影响因子：
3.1
通讯作者：
Anthony, James C.
中科院分区：
文献类型：
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作者：
Degenhardt, Louisa;Cheng, Hui;Anthony, James C.
在DSM-IV-TR中药物依赖的病例定义中明确引用了药物相关的社会角色障碍和社会适应不良。然而，在最近的流行病学研究中观察到了没有这类继发后果的药物依赖病例。当在最近的大规模精神病学调查中采取“损害/适应不良门控”方法时（例如，为了减少参与者的疲劳或负担），净效应可能包括（a）减少确定的药物依赖病例的数量和（B）与药物依赖发生相关的估计偏差。在本报告中，我们利用美国酒精及相关疾病全国流行病学调查（NESARC）的数据，对43，093名18岁及以上成年人进行了家庭调查，探讨了大麻依赖的这些问题。在这个过程中，我们阐明了上述门控方法的实际影响。具体而言，当我们模拟大麻依赖的社会障碍/适应不良“门控”评估时，最终结果是大麻依赖的估计患病率略有下降。它表明，每10000名一般人口调查答卷人中，没有上述缺陷/适应不良的大麻依赖病例不超过12例。关联模式链接可疑的背景特征的流行大麻依赖性没有明显的不同时，“门控”和“非门控”的方法被应用。总之，有理由在对大麻使用和依赖性的详细研究中采取不设门的方法。然而，在全景式心理健康调查中，“非门控”方法的效率低下必须与缺乏社会角色障碍或社会适应不良行为的大麻依赖病例的预期产量相平衡。版权所有（c）2007约翰威利父子有限公司。
Drug,related social role impairments and social maladaptation are referenced explicitly in the case definitions for drug dependence within DSM-IV-TR. Nonetheless, cases of drug dependence without this type of secondary consequence have been observed in recent epidemiological studies. When an 'impairment/maladaptation gating' approach has been taken during recent large-scale psychiatric surveys (for example, to reduce participant fatigue or burden), the net effect may include (a) a reduced number of identified drug dependence cases and (b) biases in the estimates of association linked to the occurrence of drug dependence. In this report, we probe these issues with respect to cannabis dependence, making use of data from the cross-sectional United States National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a household survey of 43,093 adults aged 18 years and over. In this process, we shed light on actual impact of the gating approach mentioned above. Specifically, when we simulated a social impairment/maladaptation 'gated' assessment of cannabis dependence, the end result was a very modest reduction in the estimated prevalence of cannabis dependence. It suggested that for every 10000 general population survey respondents there would be no more than 12 cases of cannabis dependence without the above-referenced impairments/maladaptations. Patterns of association linking suspected background characteristics to the prevalence of cannabis dependence were not appreciably different when the 'gated' and 'ungated' approaches were applied. In summary, there are reasons to take the ungated approach in detailed research on cannabis use and dependence. Nevertheless, in panoramic mental health surveys, the inefficiency of an 'ungated' approach must be balanced against the anticipated yield of cannabis dependence cases who lack social role impairments or socially maladaptive behaviours. Copyright (c) 2007 John Wiley & Sons, Ltd.