335例男性甲基苯丙胺使用者的精神病性症状相关危险因素研究

The risk factors of psychotic symptoms in 335 male methamphetamine users

目的:甲基苯丙胺的使用可以导致以幻觉妄想为主要表现的精神病性症状,通过探索影响甲基苯丙胺使用者出现幻觉妄想的相关危险因素,为预测、干预甲基苯丙胺所致精神障碍提供理论依据。方法:对2015年至2016年强制隔离戒毒所内收治的335名男性戒毒学员,根据受试者是否曾在使用物质期间出现精神病性症状而分为两组,评估其人口学情况、甲基苯丙胺使用情况等,并用Barratt冲动性人格量表(BIS-11)评估其冲动性。结果:单因素分析发现使用者年龄较小、未婚与精神病性症状相关;曾出现症状组的首次吸毒年龄(t=4.32,P<0.01)较小;曾出现症状组BIS-11总分及3个分量表得分都较高(P<0.01),脱毒前30天平均每天用量较无症状组高(P<0.01)。Logistic回归分析发现未婚[OR=3.94,95%可信区间(CI)2.12~7.30]、脱毒前30天平均吸食天数较高者(OR=1.02,95%CI 1.00~1.04)及BIS-11量表总分较高(OR=2.08,95%CI 1.30~3.33),为精神病性症状的危险因素。结论:使用者年龄小、未婚、首次吸毒年龄小、吸食量大、BIS-11量表得分较高是精神病性症状的相关因素,在临床上对未婚、吸食毒品频繁且BIS-11量表得分高的甲基苯丙胺使用者应注意评估精神状况。

Objective： Methamphetamine use can lead to psychotic symptoms,which are mainly manifested by hallucinations and delusions. We aim to provide a theoretical basis for the prediction and intervention of methamphetamine-induced mental disorder by exploring the related risk factors of methamphetamine users appear hallucinations and delusions.Methods： We divided 335 male methamphetamine users who were doing detoxification in compulsory isolated detoxification facilities from2015 to 2016 into two groups,according to whether the subjects had psychotic symptoms during the course of methamphetamine use or not. Then we assess the demographics,the use of methamphetamine,and assess their impulsivity by the Barratt Impulsiveness Scale（ BIS-11）.Results： Single factor analysis showed that the younger,unmarried users are associated with psychotic symptoms; the age of initial drug use in symptoms group（ t = 4. 32,P 0. 01） was younger,and BIS-11 total score and 3 subscalescores were also higher（ P 0. 01）,average daily drug consumption of 30 days before detoxification was higher than asymptomatic group（ P 0. 01）. Logistic regression analysis showed that unmarried [OR =3. 94,95% confidence interval（ CI） 2. 12 ~ 7. 30],higher average days of drug use in 30 days before detoxification（ OR = 1. 02,95% CI 1. 00 ~ 1. 04） and BIS-11 scores（ OR = 2. 08,95% CI 1. 30 ~ 3.33） are risk factors of psychotic symptoms.Conclusion： Young methamphetamine user unmarried,the younger age of initial drug use,taking large quantity of methamphetamine,the higher BIS-11 scores were risk factors of psychotic symptoms. We should pay attention to assessing the mental status of the methamphetamine user who is unmarried,drug consumption frequently and high BIS score in clinical.