题名

台灣K他命使用者的多重藥物使用與心身症狀、泌尿道症狀之關聯性研究

并列篇名

The Relationship between Psychosomatic and Urological Symptoms among the Multiple Drug Use of Ketamine Abusers in Taiwan

作者

謝文菁(Wen-Ching Hsieh);林楊林(Yang-Lin Lin);謝雨樵(Yu-Chiao Hsieh);詹佳祥(Chia-Hsiang Chan)

关键词

K他命 ; 多重藥物使用 ; 心身症狀 ; 泌尿道症狀 ; Ketamine ; Multiple drug use ; Psychosomatic symptoms ; Urological symptoms

期刊名称

醫學與健康期刊

卷期/出版年月

10卷3期(2021 / 11 / 01)

页次

33 - 46

内容语文

繁體中文

中文摘要

目的:多重藥物使用為現今年輕族群的用藥趨勢,而台灣K他命使用者普遍會使用多重藥物,長時間使用多種藥物會對身心造成有害影響,故本研究欲探討K他命使用者的多重藥物使用與其泌尿道症狀、心身症狀之間的相關。方法:K他命使用者需完成人口學、K他命與其他物質使用史、焦慮憂鬱症狀、依賴嚴重度及泌尿道症狀等結構式問卷,接著透過潛在類別分析區分K他命使用者的多重用藥型態,再利用多元線性回歸分析相關影響因子。結果:收錄1346位受試者,男性居多(83%)。經潛在類別分析將接受進一步評估之304位受試者區分為多重藥物使用(24%)和非多重藥物使用(76%),前者之主觀壓力、依賴嚴重度、刺激尋求、享樂缺失等分數較高,與憂鬱嚴重度增加呈現顯著相關。長時間且鼻黏膜吸食是造成泌尿道症狀的危險因子。結論:多重用藥之K他命使用者較容易出現焦慮、憂鬱及泌尿道症狀,而鼻黏膜吸食會增加泌尿道症狀出現的風險。未來應重視多重用藥問題,減少多重用藥造成的潛在傷害。

英文摘要

Objectives. Young people in the current party scene tend to use multiple drugs, one commonly abused drug being ketamine. Long-term abuse of multiple drugs can have harmful effects on physiology and psychology. This study investigated the relationship between psychosomatic and urological symptoms in multiple drug users in Taiwan who also abuse ketamine. Methods. Ketamine offenders were asked to answer a structured questionnaire collecting demographic data, ketamine and other substance use history, anxiety and depressive symptoms, Severity of Dependence Scale (SDS), and symptoms related to bladder and sexual dysfunction. A latent class analysis was employed to detect multiple drug use patterns among ketamine abusers. Multivariate regression analyses were performed to explore the relationship between these factors. Results. we recruited a total of 1,346 subjects, mostly male (83%). A total of 304 participants received further surveys and were divided in our latent class analysis into a multiple drug user (24%) and a non-multiple drug user (76%). In multiple drug users, we found a higher stress Visual Analogue Scale (VAS) score, higher SDS score, higher score of sensation-seeking scale, and higher anhedonia level to be significantly associated with increased severity of depressive symptoms. Risk of urological symptoms were significantly associated were longer use of and the sniffing of ketamine. Conclusion. Ketamine abusers who use multiple drugs experience more anxiety, depression, and urological symptoms. Ketamine use by sniffing may increase the risk of developing urological symptoms. More attention should be paid to multiple drug use to reduce the potential harm to our young people.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Carrellas, N,Wilens, TE,Anselmo, R(2016).Treatment of comorbid substance use disorders and ADHD in youth.Current Treatment Options in Psychiatry,3,15-27.
  2. Charach, A,Yeung, E,Climans, T,Lillie, E(2011).Childhood attention-deficit/hyperactivity disorder and future substance use disorders: comparative meta-analyses.Journal of the American Academy of Child & Adolescent Psychiatry,50,9-21.
  3. Chen, HC,Wu, CH,Lee, YJ,Liao, SC,Lee, MB(2005).Validity of the five-item Brief Symptom Rating Scale among subjects admitted for general health screening.Journal of the Formosan Medical Association,104,824-829.
  4. Chen, IC,Lee, MH,Chen, WC,Hu, TC,Lin, HY(2018).Risk factors of lower urinary tract syndrome among ketamine users.LUTS: Lower Urinary Tract Symptoms,10,281-286.
  5. Chen, IC,Lee, MH,Chen, WC,Hu, TC,Lin, HY(2018).Risk factors of lower urinary tract syndrome among ketamine users.LUTS: Lower Urinary Tract Symptoms,10,281-286.
  6. Chen, LY,Chen, CK,Chen, CH,Chang, HM,Huang, MC,Xu, K(2020).Association of craving and depressive symptoms in ketamine‐dependent patients undergoing withdrawal treatment.The American Journal on Addictions,29,43-50.
  7. Chen, WJ,Wu, SC,Tsay, WI(2017).Differences in prevalence, socio-behavioral correlates, and psychosocial distress between club drug and hard drug use in Taiwan: results from the 2014 National Survey of Substance Use.International Journal of Drug Policy,48,99-107.
  8. Chen, WY,Huang, MC,Lin, SK(2014).Gender Differences in subjective discontinuation symptoms associated with ketamine use.Substance abuse treatment, prevention, and policy,9,1-7.
  9. Der-Avakian, A,Markou, A(2012).The neurobiology of anhedonia and other reward-related deficits.Trends in neurosciences,35,68-77.
  10. Dervaux, A,Bayle, FJ,Laqueille, X(2001).Is substance abuse in schizophrenia related to impulsivity, sensation seeking, or anhedonia?.American Journal of Psychiatry,158,492-494.
  11. Dirks, H,Scherbaum, N,Kis, B,Mette, C(2017).ADHD in adults and comorbid substance use disorder: prevalence, clinical diagnostics and integrated therapy.Fortschritte der Neuro-logie-psychiatrie,85,336-344.
  12. Egan, TE,Dawson, AE,Wymbs, BT(2017).Substance use in undergraduate students with histories of attention-deficit/hyperactivity disorder (ADHD): the role of impulsivity.Substance use & misuse,52,1375-1386.
  13. Eme, R(2013).Male adolescent substance use disorder and attention-deficit hyperactivity disorder: a review of the iterature.International Scholarly Research Notices,1-10.
  14. Fan, N,Xu, K,Ning, Y(2016).Profiling the psychotic, depressive and anxiety symptoms in chronic ketamine users.Psychiatry research,237,311-315.
  15. Fernández-Calderón, F,Vidal-Giné, C,Rojas-Tejada, AJ,Lozano-Rojas, ÓM(2020).Patterns of simultaneous polysubstance use among partygoers: correlates and differences in adverse acute effects experienced.Journal of psychoactive drugs,52,344-356.
  16. Franken, IH,Rassin, E,Muris, P(2007).The assessment of anhedonia in clinical and non-clinical populations: further validation of the Snaith-Hamilton Pleasure Scale (SHAPS).Journal of affective disorders,99,83-89.
  17. Gorwood, P(2008).Neurobiological mechanisms of anhedonia.Dialogues Clin Neurosci,10,291-299.
  18. Ke, X,Ding, Y,Xu, K(2018).The profile of cognitive impairments in chronic ketamine users.Psychiatry research,266,124-131.
  19. Lesage, FX,Berjot, S,Deschamps, F(2012).Clinical stress assessment using a visual analogue scale.Occupational medicine,62,600-605.
  20. Li, CC,Wu, ST,Cha, TL,Sun, GH,Yu, DS,Meng, E(2019).A survey for ketamine abuse and its relation to the lower urinary tract symptoms in Taiwan.Scientific reports,9,1-6.
  21. Liang, HJ,Lau, CG,Tang, A,Chan, F,Ungvari, GS,Tang, WK(2013).Cognitive impairments in poly-drug ketamine users.Addictive behaviors,38,2661-2666.
  22. Liang, HJ,Tang, KL,Chan, F,Ungvari, GS,Tang, WK(2015).Keta-mine users have high rates of psychosis and/or depression.Journal of addictions nursing,26,8-13.
  23. Liu, YB,Hsu, CK,Chang, SJ,Yang, SS(2016).Duration of ketamine abuse was associated with lower urinary tract symptoms and low mood.Urological Science,2,23.
  24. Löwe, B,Decker, O,Müller, S(2008).Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population.Medical care,266-274.
  25. Miranda, A,Colomer, C,Berenguer, C,Roselló, R,Roselló, B(2016).Substance use in young adults with ADHD: comorbidity and symptoms of inattention and hyperactivity/impulsivity.International journal of clinical and health psychology,16,157-165.
  26. Mistry, Pain, T,Otite, U(2018).Mini review: ketamine and the urinary tract.Journal of Clinical Urology,11,200-207.
  27. Moss, HB,Chen, CM,Yi, HY(2014).Early adolescent patterns of alcohol, cigarettes, and marijuana polysubstance use and young adult substance use outcomes in a nationally representative sample.Drug and alcohol dependence,136,51-62.
  28. Ortal, S,van de Glind, G,Johan, F(2015).The role of different aspects of impulsivity as independent risk factors for substance use disorders in patients with ADHD: a review.Current drug abuse reviews,8,119-133.
  29. Phillips, JL,Norris, S,Talbot, J(2020).Single and repeated ketamine infusions for reduction of suicidal ideation in treatment-resistant depression.Neuropsychopharmacology,45,606-612.
  30. Racz, SJ,Saha, S,Trent, M(2016).Polysubstance use among minority adolescent males incarcerated for serious offenses.Child & youth care forum,45,205-220.
  31. Robles-Martínez, M,Abad, AC,Pérez-Rodríguez, V,Ros-Cucurull, E,Esojo, A,Roncero, C(2018).Delayed urinary symptoms induced by ketamine.Journal of psychoactive drugs,50,129-132.
  32. Salom, CL,Betts, KS,Williams, GM,Najman, JM,Alati, R(2016).Predictors of comorbid polysubstance use and mental health disorders in young adults-a latent class analysis.Addiction,111,156-164.
  33. Sarramon, C,Verdoux, H,Schmitt, L,Bourgeois, M(1999).Addiction and personality traits: sensation seeking, anhedonia, impulsivity.L'encephale,25,569-575.
  34. Silverstein, MJ,Alperin, S,Faraone, SV,Kessler, RC,Adler, LA(2018).Test-retest reliability of the adult ADHD Self-Report Scale (ASRS) v1. 1 Screener in non-ADHD controls from a primary care physician practice.Family practice,35,336-341.
  35. Stephenson, MT,Hoyle, RH,Palmgreen, P,Slater, MD(2003).Brief measures of sensation seeking for screening and large-scale surveys.Drug and alcohol dependence,72,279-286.
  36. Strunin, L,Díaz-Martínez, A,Díaz-Martínez, LR(2017).Age of onset, current use of alcohol, tobacco or marijuana and current polysubstance use among male and female Mexican students.Alcohol and Alcoholism,52,564-571.
  37. Su, TP,Chen, MH,Li, CT(2017).Dose-related effects of adjunctive ketamine in Taiwanese patients with treatment-resistant depression.Neuropsychopharmacology,42,2482-2492.
  38. Tang, WK,Lau, CG,Ungvari, GS,Lin, SK,Lane, HY(2019).Recovery of cognitive functioning following abstinence from ketamine.Addictive behaviors,99,106081.
  39. Tang, WK,Liang, HJ,Lau, CG,Tang, A,Ungvari, GS(2013).Relationship between cognitive impairment and depressive symptoms in current ketamine users.Journal of studies on alcohol and drugs,74,460-468.
  40. Teichman, M,Barnea, Z,Rahav, G(1989).Sensation seeking, state and trait anxiety, and depressive mood in adolescent substance users.International Journal of the Addictions,24,87-99.
  41. Tung, CK,Yeung, SW,Chiang, TP,Xu, KE,Lam, M(2014).Reliability and validity of the severity of Dependence Scale in a Chinese sample of treatment-seeking ketamine users.East Asian Archives of Psychiatry,24,156-164.
  42. Wagner, MK(2001).Behavioral characteristics related to substance abuse and risk-taking, sensation-seeking, anxiety sensitivity, and self reinforcement.Addictive behaviors,26,115-120.
  43. Wang, C,Zheng, D,Xu, J,Lam, W,Yew, DT(2013).Brain damages in ketamine addicts as revealed by magnetic resonance imaging.Frontiers in neuroanatomy,7,23.
  44. Wei, YB,Yang, JR,Wu, WW,Chinaegbomkpam, IV,Jiang, GQ(2016).Ketamine-induced lower urinary tract symptoms: a study of international prostate symptom score and quality of life.Hong Kong Journal of Emergency Medicine,23,227-233.
  45. Winstock, AR,Mitcheson, L,Gillatt, DA,Cottrell, AM(2012).The prevalence and natural history of urinary symptoms among recreational ketamine users.BJU international,110,1762-1766.
  46. Yang, SSD,Jang, MY,Lee, KH(2018).Sexual and bladder dysfunction in male ketamine abusers: a large-scale questionnaire study.PloS one,13,1-10.
  47. Yen, CH,Wu, ST,Cha, TL,Meng, E(2016).Ketamine abuse and lower urinary tract symptoms: a survey from drug rehabilitation centers in Taiwan.Urological Science,2,26-27.
  48. Zeng, H,Su, D,Jiang, X,Zhu, L,Ye, H(2016).The similarities and differences in impulsivity and cognitive ability among ketamine, methadone, and non-drug users.Psychiatry research,243,109-114.