Substance use and psychiatric phenotypes of youth experiencing homelessness: A cluster analysis.

IF 2.5 4区 医学 Q2 SUBSTANCE ABUSE
Colin W Burke, Sylvia Lanni, Bettina B Hoeppner, Peter Ducharme, Timothy E Wilens
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引用次数: 0

Abstract

Background and objectives: Due to the complex interactions of psychopathology, psychosocial stressors, and risk behaviors, characterizing high-risk phenotypic groups of transitional-age youth experiencing homelessness (TAY-EH) for targeted interventions remains difficult. We aimed to uncover specific phenotypes of TAY-EH based upon psychiatric and substance use disorder (SUD) diagnoses, and to assess relationships between these phenotypes and negative outcomes including suicidality and high-risk behaviors.

Methods: Participants (N = 140; 57% male, 54% Black) were individuals aged 16-25 years accessing support at a psychosocial agency in the U.S. Northeast. Data were gathered via structured assessment. Cluster analysis identified sub-groups of TAY-EH with differing diagnostic patterns. Bivariate analyses examined associations between cluster membership and target outcomes.

Results: A four-cluster solution was identified. Cluster 1 (Co-occurring; N = 33) was characterized by high levels of comorbidity (i.e., major depressive disorder (MDD), SUD, and notable levels of other diagnoses). Clusters 2 (MDD alone; N = 47) and 3 (SUD alone; N = 18) were characterized by single diagnoses. Cluster 4 (None; N = 42) was characterized by low levels of psychopathology. Clusters differed significantly on several variables including suicidality, adverse childhood experiences, and social connectedness. Comorbid MDD and SUD were most strongly associated with high-risk behaviors and suicidality.

Discussion and conclusions: These results highlight the importance of diagnosis and targeted interventions for co-occurring MDD and SUD to address the crisis of early mortality and other negative outcomes among TAY-EH.

Scientific significance: This study is the first to identify specific high-risk psychiatric and psychosocial phenotypes among the highly complex group of TAY-EH based upon structured diagnostic assessments.

无家可归青少年的药物使用和精神病表型:聚类分析。
背景和目标:由于精神病理学、心理社会压力因素和危险行为之间存在复杂的相互作用,因此要确定无家可归过渡年龄青少年(TAY-EH)的高风险表型群体以采取有针对性的干预措施仍然十分困难。我们的目标是根据精神病学和药物使用障碍(SUD)诊断发现过渡年龄无家可归青年的特定表型,并评估这些表型与自杀和高风险行为等负面结果之间的关系:参与者(N = 140;57% 为男性,54% 为黑人)年龄在 16-25 岁之间,在美国东北部的一家社会心理机构接受支持。数据通过结构化评估收集。聚类分析确定了具有不同诊断模式的 TAY-EH 亚群。双变量分析检验了聚类成员资格与目标结果之间的关联:结果:确定了四组解决方案。群组 1(共存;N = 33)的特点是高度共存(即重度抑郁障碍(MDD)、药物依赖性精神障碍和显著程度的其他诊断)。第 2 组(仅有 MDD;N = 47)和第 3 组(仅有 SUD;N = 18)的特点是单一诊断。群组 4(无;N = 42)的特点是精神病理学水平较低。各群组在自杀倾向、不良童年经历和社会联系等几个变量上存在明显差异。合并 MDD 和 SUD 与高危行为和自杀倾向的关系最为密切:这些结果凸显了诊断和有针对性地干预共存的 MDD 和 SUD 的重要性,以应对 TAY-EH 早期死亡和其他负面结果的危机:这项研究首次在结构化诊断评估的基础上,在高度复杂的泰勒-伊赫群体中识别出特定的高风险精神病和心理社会表型。
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来源期刊
CiteScore
5.00
自引率
0.00%
发文量
118
期刊介绍: The American Journal on Addictions is the official journal of the American Academy of Addiction Psychiatry. The Academy encourages research on the etiology, prevention, identification, and treatment of substance abuse; thus, the journal provides a forum for the dissemination of information in the extensive field of addiction. Each issue of this publication covers a wide variety of topics ranging from codependence to genetics, epidemiology to dual diagnostics, etiology to neuroscience, and much more. Features of the journal, all written by experts in the field, include special overview articles, clinical or basic research papers, clinical updates, and book reviews within the area of addictions.
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