وقوع آسیب شناسی روانی در گروهی از کاربران جوان هروئین و/یا کوکائین

A prospective study was carried out in Barcelona, Spain, to determine the incidence of mental disorders including substance use disorders (SUDs). From a cohort of 288 young adult (aged 18–30 years) cocaine and/or heroin users recruited in nonclinical settings, 158 were reinterviewed 18 months later using the Psychiatric Research Interview for Substance and Mental Disorders. During follow-up, 18% of subjects presented a new SUD, and nearly 11% a new non-SUD Axis I disorder. Incidence was highest for mood disorders (8%). Being a woman, a lower frequency of substance use at baseline, a younger age of heroin first use, and a worsening of SUD were associated with a higher likelihood of presenting a new Axis I disorder. Having received drug treatment ever (at baseline) or during follow-up was not associated with progress of SUD. An overall improvement in the psychiatric status of these young substance users was observed.

Large-scale epidemiologic surveys in adult U.S. and European populations have shown that substance use disorders (SUDs) are characterized by considerable comorbidity with other mental disorders (the so-called dual diagnosis; Compton et al., 2005 and Pavarin, 2006). At the same time, community and clinical studies on substance-using and substance-abusing youths have also reported a higher prevalence of psychiatric problems related to substance use (Armstrong & Costello, 2002 and Chan et al., 2008). On the other hand, high prevalence of co-occurrence of substance and non-substance use psychiatric disorders has been reported among adult opioid and/or cocaine users in clinical samples (Astals et al., 2008, Cacciola et al., 2001, Falck et al., 2004, Nocon et al., 2007 and Watkins et al., 2004), with lifetime rates of psychiatric disorders ranging between 34% and 86%. Moreover, it is well known that comorbid substance dependence is associated with a more severe course of non-SUD disorders and that these long-term independent syndromes produce greater difficulty in treating the associated SUD (Boden and Moos, 2009, McGovern et al., 2006, Rounsaville, 2004 and Weiser et al., 2003).