PDF(Pubmed)
Abstract：
Use of illegal stimulants is associated with an increased risk of psychotic disorder. However, the impact of stimulant use on odds of first-episode psychosis (FEP) remains unclear. Here, we aimed to describe the patterns of stimulant use and examine their impact on odds of FEP.
We included patients with FEP aged 18-64 years who attended psychiatric services at 17 sites across 5 European countries and Brazil, and recruited controls representative of each local population (FEP = 1130; controls = 1497). Patterns of stimulant use were described. We computed fully adjusted logistic regression models (controlling for age, sex, ethnicity, cannabis use, and education level) to estimate their association with odds of FEP. Assuming causality, we calculated the population-attributable fractions for stimulant use associated with the odds for FEP.
Prevalence of lifetime and recent stimulant use in the FEP sample were 14.50% and 7.88% and in controls 10.80% and 3.8%, respectively. Recent and lifetime stimulant use was associated with increased odds of FEP compared with abstainers [fully adjusted odds ratio 1.74,95% confidence interval (CI) 1.20-2.54, P = .004 and 1.62, 95% CI 1.25-2.09, P < .001, respectively]. According to PAFs, a substantial number of FEP cases (3.35% [95% CI 1.31-4.78] for recent use and 7.61% [95% CI 3.68-10.54] for lifetime use) could have been prevented if stimulants were no longer available and the odds of FEP and PAFs for lifetime and recent stimulant use varied across countries.
Illegal stimulant use has a significant and clinically relevant influence on FEP incidence, with varying impacts across countries.
We included patients with FEP aged 18-64 years who attended psychiatric services at 17 sites across 5 European countries and Brazil, and recruited controls representative of each local population (FEP = 1130; controls = 1497). Patterns of stimulant use were described. We computed fully adjusted logistic regression models (controlling for age, sex, ethnicity, cannabis use, and education level) to estimate their association with odds of FEP. Assuming causality, we calculated the population-attributable fractions for stimulant use associated with the odds for FEP.
Prevalence of lifetime and recent stimulant use in the FEP sample were 14.50% and 7.88% and in controls 10.80% and 3.8%, respectively. Recent and lifetime stimulant use was associated with increased odds of FEP compared with abstainers [fully adjusted odds ratio 1.74,95% confidence interval (CI) 1.20-2.54, P = .004 and 1.62, 95% CI 1.25-2.09, P < .001, respectively]. According to PAFs, a substantial number of FEP cases (3.35% [95% CI 1.31-4.78] for recent use and 7.61% [95% CI 3.68-10.54] for lifetime use) could have been prevented if stimulants were no longer available and the odds of FEP and PAFs for lifetime and recent stimulant use varied across countries.
Illegal stimulant use has a significant and clinically relevant influence on FEP incidence, with varying impacts across countries.
摘要：
背景：使用非法兴奋剂与精神病的风险增加有关。然而,兴奋剂使用对首发精神病(FEP)几率的影响尚不清楚.这里,我们旨在描述兴奋剂使用的模式,并研究其对FEP几率的影响.
方法：我们纳入了18-64岁的FEP患者，他们在5个欧洲国家和巴西的17个地点接受了精神科服务。并招募代表每个当地人群的对照（FEP=1130；对照=1497）。描述了兴奋剂使用的模式。我们计算了完全调整的逻辑回归模型(控制年龄，性别,种族,使用大麻,和教育水平）来估计它们与FEP几率的关联。假设因果关系，我们计算了与FEP几率相关的兴奋剂使用的人群归因分数.
结果：FEP样本中寿命和最近使用兴奋剂的患病率分别为14.50％和7.88％，对照组为10.80％和3.8％，分别。与弃权者相比，近期和终生使用兴奋剂与FEP的几率增加相关[完全调整后的优势比1.74,95％置信区间（CI）1.20-2.54，P=.004和1.62，95％CI1.25-2.09，P<.001，分别]。根据PAF，如果不再使用兴奋剂,而且各国终生使用和近期使用兴奋剂的FEP和PAF的几率不同,则可以预防大量FEP病例(近期使用3.35%[95%CI1.31~4.78]和终生使用7.61%[95%CI3.68~10.54]).
结论：非法使用兴奋剂对FEP发生率具有显著的临床相关性影响，各国影响不同。
方法：我们纳入了18-64岁的FEP患者，他们在5个欧洲国家和巴西的17个地点接受了精神科服务。并招募代表每个当地人群的对照（FEP=1130；对照=1497）。描述了兴奋剂使用的模式。我们计算了完全调整的逻辑回归模型(控制年龄，性别,种族,使用大麻,和教育水平）来估计它们与FEP几率的关联。假设因果关系，我们计算了与FEP几率相关的兴奋剂使用的人群归因分数.
结果：FEP样本中寿命和最近使用兴奋剂的患病率分别为14.50％和7.88％，对照组为10.80％和3.8％，分别。与弃权者相比，近期和终生使用兴奋剂与FEP的几率增加相关[完全调整后的优势比1.74,95％置信区间（CI）1.20-2.54，P=.004和1.62，95％CI1.25-2.09，P<.001，分别]。根据PAF，如果不再使用兴奋剂,而且各国终生使用和近期使用兴奋剂的FEP和PAF的几率不同,则可以预防大量FEP病例(近期使用3.35%[95%CI1.31~4.78]和终生使用7.61%[95%CI3.68~10.54]).
结论：非法使用兴奋剂对FEP发生率具有显著的临床相关性影响，各国影响不同。
