Loading...
|
Please use this identifier to cite or link to this item:
https://ir.csmu.edu.tw:8080/ir/handle/310902500/3040
|
| Title: | 保護管束青少年非法藥物使用之追蹤研究：用藥型態、疾病率、共病率及心理社會因子之探討 |
| Authors: | 楊浩然;梁雅萍
Yang, Hao-Jan;Liang, Ya-Ping |
| Contributors: | 中山醫學大學公共衛生系 |
| Keywords: | 非法藥物;青少年;精神疾患;共病;心理社會因子 |
| Date: | 2007 |
| Issue Date: | 2010-12-06T03:23:48Z (UTC)
|
| Abstract: | 研究目的：本研究欲探討非因非法藥物接受保護管束處分之青少年藥物使用盛行率、精神疾患共病率及其相關之心理社會因子。研究方法：以台灣中、北部五所地方法院中，接受保護管束半年之內，且具有閱讀能力之青少年為研究對象(n=1356)，參與研究之青少年均完成一份包含關於非法藥物使用經驗及精神疾病狀態以(The Mini International Neuropsychiatric Interview)評估及性格以(Tridimensional Personality Questionnaire)評估、家庭功能以(Family Adaptability and Cohesion Evaluation Scale)評估、生活事件以(Life Event Checklist)評估在內的問卷。研究為追蹤式設計，目前為第一年基線之調查。在本年度分析中，非法藥物使用及疾病盛行率、共病率，以百分比加以描述，並在「使用」及「未使用」非法藥物之兩組青少年間，以卡方檢定加以分析差異。性格、家庭功能分數及生活事件數目則以t檢定比較差異。單變項及多變項邏輯斯迴歸模式用以探討各種因素對青少年使用非法藥物之影響。主要發現：台灣中、北部五所地方法院中接受保護管束之青少年，物質使用的情形相當盛行。其中合法物質中，香菸、酒、檳榔及提神飲料都有接近五成以上的盛行率；而非法物質中也有6%的盛行率。保護管束青少年的非法物質使用類別，以笑氣(1.3%)的使用最為盛行。其次為搖頭丸(1.2%)及安非他命(1.0%)。接受保護管束之青少年，精神疾患之盛行率相當高。其中以自殺傾向(29.5%)、精神病性疾患(29.9%)、反社會性人格疾患(10.5%)、及情感性疾患(10.1% - 19.9%)最為盛行。若保護管束青少年曾使用非法藥物，則精神疾患的共病率更高，超過五成使用藥物青少年具有自殺傾向(53%)及精神病性疾患(56%)，而重鬱症(38%)、雙極性情感疾患(40%)、恐慌症(41%)、以及反社會人格(27%)也有相當高的共病率。另外，非法藥物的使用與精神疾患之間有顯著的相關(勝算比均顯著異於1)。保護管束青少年的人格與一般青少年不同，其家庭功能比較一般青少年來的差，而他們的生活事件數目也比一般青少年來的多。不過依非法藥物的使用加以分組，則三種心理社會變項中，僅人格為可能的危險因子，家庭功能及生活事件似乎與非法物質的使用無關。多變項分析的結果則進一步指出，在納入研究的基本人口學、精神疾患、性格、家庭功能、生活事件均加以控制之後，僅反社會人格(OR=2.79, 95% CI =1.48-5.26)及精神病性疾患(OR=2.41, 95% CI =1.33-4.38)與青少年非法藥物之使用有關。結論及建議：「俱樂部藥」是保護管束青少年中常見的藥物，尤其是笑氣的高盛行率值得有關單位注意。除了物質濫用的問題之外，精神疾患的問題在法院保護管束的青少年中也是一個相當值得重視的問題。尤其是曾經使用非法藥物之青少年，許多精神疾患之共病率較未曾使用者高，且在所有因素中，僅精神疾患與青少年非法使用藥物有關。未來醫療衛生相關單位在思考物質濫用問題之政策時，應同時將心理疾患納入考慮，並可透過與司法單位合作針對保護管束青少年等高危險加以介入。
Purpose: The present study aims at investigating the prevalence, comorbidity with psychopathology, and psychosocial risk factors of illicit drug use among juveniles under probation or parole. Methods: Juveniles (n=1356) under probation or parole within half year and are capable to read from five courts located at northern or central Taiwan were consecutively selected and complete a series questionnaires comprising substance use and psychiatric disorders (The Mini International Neuropsychiatric Interview), family functioning (Family Adaptability and Cohesion Evaluation Scale), and life events (Life Event Checklist). This is the baseline of the follow-up study. We present the prevalence rates of illicit drug use and psychiatric morbidity and comorbidity using percentage. To compare the rates between those who with and without illicit drug use, the chi-square test is used. Scores of personality traits and family functioning as well as the number of life events were compared with t-test, univariable and multivariable logistic regretssion models were employeed to examine the effects of such factors on adolescent illicit drug use. Main findings: The prevalence rates of substance use/abuse among juveniles under probation or parole were substantial. In terms of legal substances, a prevalence of nearly half or more was found in cigarettes, alcohol, betel nuts, and refreshing beverages; while there was 6% of subjects using illicit drugs. The most common used illicit drug is nitrous oxide (1.3%), followed by ecstasy (1.2%) and amphetamine (1.0%). The prevalence rates of psychiatric disorders were also high among juveniles under probation, especially in suicide ideation or attempt (29.5%), psychosis (29.9%), antisocial personality disorder (10.5%), and mood disorders (10.1-19.9%). The comorbidity rates of psychiatric disorders went higher if subjects ever tried illicit drugs. More than half of adolescents who used illicit drugs suffer from suicidality (53%) orpsychotic disorder (56%). Major depression (38%), bipolar disorder (40%), panic disorder (41%), and antisocial personality disorder (27%) also show high comorbidities. There were significant associations between illicit drug use and psychiatric disorders (ORs all significantly different from 1). Compared to adolescents in general population, juveniles under probation were with higher scores of personality traits; worse family functions; and more life events. However, with respect to the use of illicit drug, only personality traits exhibit significant relationships. Multiple logistic regression analyses further reveal that only antisociall personality disorder (OR=2.79) and psychotic disoreder (OR=2.41) are associated with adolescent illicit drug use after controlling for all sociodemographic, psychiatric personality, family functioning, and life event variables. Conclusions and suggestions: “Club drugs” such as ecstasy and amphetamine were prevalent in juveniles under probation. In addition, the present study also highlighted the nitrous oxide were the most common illicit drug, which warrant further surveillance and investigation. In addition to the substance use/abuse problems, the high prevalence of psychopathology among juveniles under probation is also a problem to be notice, especially among those ever tired illicit drugs, the comorbidity with many psychiatric disorders are found to be associated with adolescent illicit drug use among all factors in this study. In considering the future strategies about the intervention of substance use/abuse in adolescents, it should take mental problems into account and cooperate with judicial institutes to prevent the high risk groups such as juveniles under probation from using illicit drugs. |
| URI: | https://ir.csmu.edu.tw:8080/handle/310902500/3040 |
| Appears in Collections: | [公共衛生學系暨碩士班] 研究計劃
|
Files in This Item:
| File |
Description |
Size | Format | |
|---|
| 楊浩然.pdf | 國科會計劃報告書 | 4557Kb | Adobe PDF | 1616 | View/Open |
|
All items in CSMUIR are protected by copyright, with all rights reserved.
|
