Predictors and Correlates of Positive Urine Drug Screening in a Retrospective Cohort Analysis of Child and Adolescent Psychiatry Inpatients Throughout the COVID-19 Pandemic.

Sean Lynch, Timothy Becker, Parul Shanker, Dalton Martin, Paige Staudenmaier, Alicia Leong, Timothy Rice
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Abstract

Background and objectives: Youth substance use is associated with significant psychological, neurological, and medical complications. Risk factors for substance use among children and adolescents in the general population include peer and/or parental substance use, certain psychiatric illnesses (eg, Attention-Deficit/Hyperactivity Disorder, depression), and history of maltreatment. Co-occurring substance use and psychiatric illness have been associated with increased suicidality, but few prior studies have characterized substance use among child/adolescent inpatients. As such, it remains unclear how substance use contributing to acute psychiatric presentations has changed since the start of the COVID-19 pandemic.

Methods: This is a retrospective cohort study of 816 unique child/adolescent psychiatry inpatients with urine drug screening (UDS) results from a diverse urban setting. Charts of patients hospitalized between June 1, 2018 and November 30, 2021 were reviewed for sociodemographic characteristics, indication for admission, psychiatric history, hospital course, treatment plan, and discharge diagnosis. Differences in sociodemographic and clinical characteristics, such as age, race, and diagnoses, between patients with and without positive UDS were explored throughout various periods of the COVID-19 pandemic. Descriptive and comparative statistics were performed, as well as a logistic regression model to identify the predictors of positive UDS.

Results: Of the study sample, 18% had a positive UDS. Older age, diagnosis of impulsive or behavioral disorder, and a history of violence were found to be predictors of positive UDS. Asian/South Asian or Hispanic/LatinX race and history of a developmental or intellectual disability were found to be negative predictors. The frequency of positive UDS in this population did not change based on COVID-19.

Discussion and conclusions: Multiple factors may predispose children and adolescents to substance use. Though no impact of COVID-19 was found in this sample, longer-term studies are needed.

Scientific significance: This study identifies independent predictors of active substance use in the child and adolescent psychiatric inpatient population.

在整个 COVID-19 大流行期间对儿童和青少年精神病住院患者进行的回顾性队列分析中,尿液药物筛查阳性的预测因素和相关因素。
背景和目标:青少年使用药物与严重的心理、神经和医疗并发症有关。一般人群中儿童和青少年使用药物的风险因素包括同伴和/或父母使用药物、某些精神疾病(如注意力缺陷/多动障碍、抑郁症)以及虐待史。药物使用和精神疾病的共存与自杀倾向的增加有关,但此前很少有研究对儿童/青少年住院患者的药物使用情况进行描述。因此,目前仍不清楚自 COVID-19 大流行以来,导致急性精神病症状的药物使用情况发生了怎样的变化:这是一项回顾性队列研究,研究对象是来自不同城市环境的 816 名有尿液药物筛查(UDS)结果的儿童/青少年精神病住院患者。研究人员查阅了 2018 年 6 月 1 日至 2021 年 11 月 30 日期间住院患者的病历,以了解其社会人口学特征、入院指征、精神病史、住院过程、治疗方案和出院诊断。在 COVID-19 大流行的各个时期,探讨了 UDS 呈阳性和未呈阳性的患者在社会人口学和临床特征(如年龄、种族和诊断)方面的差异。研究采用了描述性和比较性统计方法,并利用逻辑回归模型确定了 UDS 阳性的预测因素:在研究样本中,18% 的人 UDS 呈阳性。研究发现,年龄较大、被诊断为冲动或行为障碍以及有暴力史是 UDS 呈阳性的预测因素。亚裔/南亚裔或西班牙裔/拉美裔人种以及发育障碍或智力障碍史则是负面的预测因素。根据 COVID-19,该人群中 UDS 呈阳性的频率没有变化:多种因素可能导致儿童和青少年使用药物。尽管在该样本中未发现 COVID-19 的影响,但仍需进行更长期的研究:本研究确定了儿童和青少年精神病住院患者中药物使用的独立预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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