Development of Alcohol and Drug Use in Youth With Manic Symptoms

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• 作者：Sarah McCue Horwitz ; PhD^a ; ^{Sarah.Horwitz@nyumc.org} ; Amy Storfer-Isser ; PhD^b ; Andrea S. Young ; PhD^c ; Eric A. Youngstrom ; PhD^d ; H. Gerry Taylor ; PhD^e ; Thomas W. Frazier ; PhD^f ; L. Eugene Arnold ; MD^g ; Mary A. Fristad ; PhD ; ABPP^g ; Boris Birmaher ; MD^h ; Robert L. Findling ; MD ; MBA^c
• 关键词：manic symptoms ; substance use ; bipolar disorders
• 刊名：Journal of the American Academy of Child & Adolescent Psychiatry
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：56
• 期：2
• 页码：149-156
• 全文大小：172 K
• 卷排序：56

文摘

This analysis examined alcohol and drug use over a 6-year follow-up of children in the Longitudinal Assessment of Manic Symptoms (LAMS) study.MethodLAMS screened 6- to 12.9-year-old children visiting 9 child outpatient mental health (MH) clinics, using the Parent General Behavior Inventory 10-item mania scale. All children with scores ≥12 and a matched group with scores ≤12 were invited to enroll. Children were assessed every 6 months. Assessments included demographics, family, MH history, child diagnoses, child stress, and alcohol and drug use. Univariate, bivariate, and interval censored survival analyses were conducted.ResultsOf those >9 years at baseline, 34.9% used alcohol at least once, with 11.9% regular users; 30.1% used drugs at least once, with 16.2% regular users. Predictors of any alcohol use were parental marital status, older age at study entry, a primary diagnosis of disruptive behavior disorders at baseline, and number of impactful child life events. Predictors of regular alcohol use included parental marital status, age, and sustained high mania symptoms over the first 24 months of follow-up. Predictors of any drug use were single parent, parental substance use, and stressful child life events. Predictors of regular drug use were parental marital status, stressful child life events, and a baseline disruptive behavior disorder diagnosis. Baseline medications decreased the risk of regular drug use.ConclusionLongitudinal data on youth with elevated manic symptoms suggest that comorbid disruptive behavior disorder, manic symptom burden, family environment, and stress are predictors of initiation and regular use of substances.