甲基苯丙胺使用人群中焦虑症状特征及危险因素分析

Chracterstics and risk factors of anxiety symptoms among methamphetamine users

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.