甲基苯丙胺使用人群中焦虑症状特征及危险因素分析
|
摘要
目的:了解甲基苯丙胺(MA,俗称"冰毒")滥用人群的流行病学特征及该人群中焦虑症状的危险因素。方法:对来自北京市和深圳市的强制隔离戒毒机构中主要滥用物质为MA的共2644名人员进行问卷调查,并对该人群中焦虑症状患病率及其危险因素进行分析。本研究使用汉密尔顿焦虑量表(HAMA)评定研究对象的焦虑症状。结果:MA使用人群多是年龄较大、汉族、低学历男性; 289(10. 97%)名调查对象有多药滥用经历,其中有28. 69%的人曾经使用过海洛因,且有超过一半(56. 55%)的调查对象有MA依赖;有将近三分之一(29. 39%)的MA滥用者患有焦虑症状。多因素logistic回归分析结果显示每天使用MA(比值比(OR)=1. 80,95%confidence interval [95%CI]:1. 34-2. 42)、每次≥0. 2 g的使用剂量(1. 50,1. 18-1. 92)、使用MA的同时还是用其他毒品(2. 33,1. 37-3. 96)及抑郁症状(2. 13,1. 67-2. 70)和精神病性症状(9. 53,6. 99-13. 00)是焦虑症状的危险因素,而高中及以上的受教育水平(0. 64,0. 46-0. 89)、无业(0. 52,0. 40-0. 66)及参加过戒毒治疗(0. 46,0. 33-0. 65)是焦虑症状的保护因素。结论:焦虑症状是MA滥用人群中常见的精神症状,有近三分之一的MA使用者停止使用MA后会出现焦虑症状,我们可以通过积极治疗精神疾病共病、减少MA使用、进行戒毒治疗等措施来改善MA使用者的焦虑症状。
Objective: To understand the characteristics and the risk factors of anxiety symptoms among the methamphetamine( MA) users in China.Methods: A cross-sectional study was conducted between April,2012 and October,2015 among individuals for whom MA was the principal drug of use in Compulsory Drug Detoxification Centers in Beijing and Shenzhen Province( n = 2644). Demographic,drug use and anxiety characteristics were examined using a specifically-designed questionnaire and Hamilton Anxiety Scale( HAMA). Logistic regression was performed to explore the risk factors for anxiety symptoms in this population.Results: Participants were predominantly aged 30 or above,Han Chinese men,with limited education. 289( 10. 97%) of the participants had experienced polydrug use,and 28. 69% of MA users had heroin use history,and 54. 25% participants satisfied the diagnosis of MA dependence; 29. 39% MA users had anxiety symptoms. Multiple Logistic regression analysis showed that depression symptoms,MA-associated psychosis symptoms,use MA every day,use MA ≥0. 2 g per time,and use MA while using other drugs was risk factors for anxiety symptoms with adjusted odds ratios( aORs) of 2. 13( 95% confidence interval [95% CI]: 1. 67-2. 70),9. 53( 6. 99-13. 00),1. 80( 1. 34-2. 42),1. 50( 1. 18-1. 92) and 2. 33( 1. 37-3. 96) respectively. And the anxiety symptoms were less common among higher education participants( 0. 64,0. 46 – 0. 89),unemployed participants( 0. 52,0. 40-0. 66) and individuals who had participated in previous drug treatment( 0. 46,0. 33-0. 65).Conclusion: Anxiety symptoms are common psychiatric symptoms in the MA abuse population,nearly one third of the MA users had anxiety symptoms after abstinence. The efforts that control comorbid psychiatric symptoms,facilitate drug users ' attempts to reduce MA use,and participated in drug treatment should be supported because of their potential contribution to prevent the anxiety symptoms in this population.
Objective: To understand the characteristics and the risk factors of anxiety symptoms among the methamphetamine( MA) users in China.Methods: A cross-sectional study was conducted between April,2012 and October,2015 among individuals for whom MA was the principal drug of use in Compulsory Drug Detoxification Centers in Beijing and Shenzhen Province( n = 2644). Demographic,drug use and anxiety characteristics were examined using a specifically-designed questionnaire and Hamilton Anxiety Scale( HAMA). Logistic regression was performed to explore the risk factors for anxiety symptoms in this population.Results: Participants were predominantly aged 30 or above,Han Chinese men,with limited education. 289( 10. 97%) of the participants had experienced polydrug use,and 28. 69% of MA users had heroin use history,and 54. 25% participants satisfied the diagnosis of MA dependence; 29. 39% MA users had anxiety symptoms. Multiple Logistic regression analysis showed that depression symptoms,MA-associated psychosis symptoms,use MA every day,use MA ≥0. 2 g per time,and use MA while using other drugs was risk factors for anxiety symptoms with adjusted odds ratios( aORs) of 2. 13( 95% confidence interval [95% CI]: 1. 67-2. 70),9. 53( 6. 99-13. 00),1. 80( 1. 34-2. 42),1. 50( 1. 18-1. 92) and 2. 33( 1. 37-3. 96) respectively. And the anxiety symptoms were less common among higher education participants( 0. 64,0. 46 – 0. 89),unemployed participants( 0. 52,0. 40-0. 66) and individuals who had participated in previous drug treatment( 0. 46,0. 33-0. 65).Conclusion: Anxiety symptoms are common psychiatric symptoms in the MA abuse population,nearly one third of the MA users had anxiety symptoms after abstinence. The efforts that control comorbid psychiatric symptoms,facilitate drug users ' attempts to reduce MA use,and participated in drug treatment should be supported because of their potential contribution to prevent the anxiety symptoms in this population.
引文
[1]United Nations Office on Drugs and Crime. Vienna:United Nations Office on Drugs and Crime,2017.
[2]国家食品药品监督管理总局.国家食品药品监督管理总局,2016.
[3]中国国家禁毒委员办公室.中国国家禁毒委员办公室,2017.
[4]郭东文,郑继旺.认识MA远离MA[J].中国药物滥用防治杂志,1998,(4):14-17.
[5]胡早秀,于建云,李桢.甲基苯丙胺的毒性及危害[J].中国药物滥用防治杂志,2005,(4):228-230.
[6]Swan N. Response to Escalating Methamphetamine Abuse Builds on NIDA-Funded research[J]. NIDA NOTES,1996,11(1,5,6,18).
[7]郑继旺.苯丙胺类兴奋剂的行为药理[J].中国药物依赖性通报,1993,(3):159-163.
[8]韩玲娜,王春雷,张莉.外侧缰核中5-HT_(2C)受体在帕金森病模型大鼠焦虑行为中的调节作用及其机制[J].吉林大学学报(医学版),2016,42(3):473-480.
[9]张兵,李扬.针对谷氨酸能系统的抗抑郁药物的研究进展[J].中国药理学通报,2014,30(9):1197-200.
[10]宋灵云,李苗苗,于海玲.芥酸酰胺对小鼠的抗焦虑样作用[J].沈阳药科大学学报,2017,34(4):333-337.
[11]王延丽,石晋丽,赵保胜.焦虑症的发生机制研究进展[C].中华中医药学会第十届中药鉴定学术会议暨WHO中药材鉴定方法和技术研讨会,中国陕西西安,F,2010.
[12]陈兆斌,张博,刘秀敏,等.焦虑症发病机制的研究进展[J].天津中医药,2018,35(4):316-320.
[13]Akindipe T,Wilson D,Stein D J. Psychiatric disorders in individuals with methamphetamine dependence:prevalence and risk factors[J]. Metab Brain Dis,2014,29(2):351-357.
[14] Eslami-Shahrbabaki M,Fekrat A,Mazhari S. A study of the prevalence of psychiatric disorders in patients with methamphetamine-induced psychosis[J]. Addict Health,2015,7(1-2):37-46.
[15]Bao Y P,Qiu Y,Yan S Y,et al. Pattern of drug use and depressive symptoms among amphetamine type stimulants users in Beijing and Guangdong province,China[J]. Plo S one,2013,8(4):e60544.
[16]Leucht S,Kane J M,Kissling W,et al. What does the PANSS mean?[J]. Schizophr Res,2005,79(2-3):231-238.
[17]Fan N,Xu K,Ning Y,et al. Profiling the psychotic,depressive and anxiety symptoms in chronic ketamine users[J].Psychiatry Res,2016,237:311-315.
[18]Tang Y H,Zhang M Y. Hamilton anxiety scale(HAMA)[J]. Shanghai Arch Psychiatry,1984,(2):64-65.
[19]张明园汤.汉密顿焦虑量表[J].上海精神医学,1984,(2):64-65.
[20]Mcgregor C,Srisurapanont M,Jittiwutikarn J,et al. The nature,time course and severity of methamphetamine withdrawal[J].Addiction(Abingdon,England),2005,100(9):1320-1329.
[21]Brecht ML,Von Mayrhauser C,Anglin MD. Predictors of relapse after treatment for methamphetamine use[J]. J Psychoactive Drugs,2000,32(2):211-220.
[22]Su MF,Liu MX,Li JQ,et al. Epidemiological Characteristics and Risk Factors of Methamphetamine-Associated Psychotic Symptoms[J]. Front Psychiatry,2018,9:489.
[23]Phillips MR,Zhang J,Shi Q,et al. Prevalence,treatment,and associated disability of mental disorders in four provinces in China during 2001-05:an epidemiological survey[J]. The Lancet,2009,373(9680):2041-2053.
[24]Su H,Zhang J,Ren W,et al. Anxiety level and correlates in methamphetamine-dependent patients during acute withdrawal[J]. Medicine(Baltimore),2017,96(15):e6434-e.
[25]Zorick T,Nestor L,Miotto K,et al. Withdrawal symptoms in abstinent methamphetamine-dependent subjects[J]. Addiction(Abingdon,England),2010,105(10):1809-1818.
[26]Ma J,Sun XJ,Wang RJ,et al. Profile of psychiatric symptoms in methamphetamine users in China:Greater risk of psychiatric symptoms with a longer duration of use[J]. Psychiatry Res,2018,262:184-192.
[27] Jang CG,Whitfield T,Schulteis G,et al. A dysphoric-like state during early withdrawal from extended access to methamphetamine self-administration in rats[J]. Psychopharmacology,2013,225(3):753-763.
[28]Koob GF,Ahmed SH,Boutrel B,et al. Neurobiological mechanisms in the transition from drug use to drug dependence[J].Neurosci Biobehav Rev,2004,27(8):739-749.
[29]杜颖,谭常赞,刘祺,等.甲基苯丙胺依赖与其他精神障碍共病情况及相关因素研究[J].中国当代医药,2018,25(15):8-11.
[2]国家食品药品监督管理总局.国家食品药品监督管理总局,2016.
[3]中国国家禁毒委员办公室.中国国家禁毒委员办公室,2017.
[4]郭东文,郑继旺.认识MA远离MA[J].中国药物滥用防治杂志,1998,(4):14-17.
[5]胡早秀,于建云,李桢.甲基苯丙胺的毒性及危害[J].中国药物滥用防治杂志,2005,(4):228-230.
[6]Swan N. Response to Escalating Methamphetamine Abuse Builds on NIDA-Funded research[J]. NIDA NOTES,1996,11(1,5,6,18).
[7]郑继旺.苯丙胺类兴奋剂的行为药理[J].中国药物依赖性通报,1993,(3):159-163.
[8]韩玲娜,王春雷,张莉.外侧缰核中5-HT_(2C)受体在帕金森病模型大鼠焦虑行为中的调节作用及其机制[J].吉林大学学报(医学版),2016,42(3):473-480.
[9]张兵,李扬.针对谷氨酸能系统的抗抑郁药物的研究进展[J].中国药理学通报,2014,30(9):1197-200.
[10]宋灵云,李苗苗,于海玲.芥酸酰胺对小鼠的抗焦虑样作用[J].沈阳药科大学学报,2017,34(4):333-337.
[11]王延丽,石晋丽,赵保胜.焦虑症的发生机制研究进展[C].中华中医药学会第十届中药鉴定学术会议暨WHO中药材鉴定方法和技术研讨会,中国陕西西安,F,2010.
[12]陈兆斌,张博,刘秀敏,等.焦虑症发病机制的研究进展[J].天津中医药,2018,35(4):316-320.
[13]Akindipe T,Wilson D,Stein D J. Psychiatric disorders in individuals with methamphetamine dependence:prevalence and risk factors[J]. Metab Brain Dis,2014,29(2):351-357.
[14] Eslami-Shahrbabaki M,Fekrat A,Mazhari S. A study of the prevalence of psychiatric disorders in patients with methamphetamine-induced psychosis[J]. Addict Health,2015,7(1-2):37-46.
[15]Bao Y P,Qiu Y,Yan S Y,et al. Pattern of drug use and depressive symptoms among amphetamine type stimulants users in Beijing and Guangdong province,China[J]. Plo S one,2013,8(4):e60544.
[16]Leucht S,Kane J M,Kissling W,et al. What does the PANSS mean?[J]. Schizophr Res,2005,79(2-3):231-238.
[17]Fan N,Xu K,Ning Y,et al. Profiling the psychotic,depressive and anxiety symptoms in chronic ketamine users[J].Psychiatry Res,2016,237:311-315.
[18]Tang Y H,Zhang M Y. Hamilton anxiety scale(HAMA)[J]. Shanghai Arch Psychiatry,1984,(2):64-65.
[19]张明园汤.汉密顿焦虑量表[J].上海精神医学,1984,(2):64-65.
[20]Mcgregor C,Srisurapanont M,Jittiwutikarn J,et al. The nature,time course and severity of methamphetamine withdrawal[J].Addiction(Abingdon,England),2005,100(9):1320-1329.
[21]Brecht ML,Von Mayrhauser C,Anglin MD. Predictors of relapse after treatment for methamphetamine use[J]. J Psychoactive Drugs,2000,32(2):211-220.
[22]Su MF,Liu MX,Li JQ,et al. Epidemiological Characteristics and Risk Factors of Methamphetamine-Associated Psychotic Symptoms[J]. Front Psychiatry,2018,9:489.
[23]Phillips MR,Zhang J,Shi Q,et al. Prevalence,treatment,and associated disability of mental disorders in four provinces in China during 2001-05:an epidemiological survey[J]. The Lancet,2009,373(9680):2041-2053.
[24]Su H,Zhang J,Ren W,et al. Anxiety level and correlates in methamphetamine-dependent patients during acute withdrawal[J]. Medicine(Baltimore),2017,96(15):e6434-e.
[25]Zorick T,Nestor L,Miotto K,et al. Withdrawal symptoms in abstinent methamphetamine-dependent subjects[J]. Addiction(Abingdon,England),2010,105(10):1809-1818.
[26]Ma J,Sun XJ,Wang RJ,et al. Profile of psychiatric symptoms in methamphetamine users in China:Greater risk of psychiatric symptoms with a longer duration of use[J]. Psychiatry Res,2018,262:184-192.
[27] Jang CG,Whitfield T,Schulteis G,et al. A dysphoric-like state during early withdrawal from extended access to methamphetamine self-administration in rats[J]. Psychopharmacology,2013,225(3):753-763.
[28]Koob GF,Ahmed SH,Boutrel B,et al. Neurobiological mechanisms in the transition from drug use to drug dependence[J].Neurosci Biobehav Rev,2004,27(8):739-749.
[29]杜颖,谭常赞,刘祺,等.甲基苯丙胺依赖与其他精神障碍共病情况及相关因素研究[J].中国当代医药,2018,25(15):8-11.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |