請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/21681
標題: | 愷他命使用者之泌尿道與心身症狀分析 Psychosomatic and lower urinary tract symptoms among ketamine abusers |
作者: | Han-Ting Wei 衛漢庭 |
指導教授: | 鍾國彪(Kuo-Piao Chung) |
共同指導教授: | 莊苹(Ping Chung) |
關鍵字: | 愷他命濫用,心身症狀,下泌尿道症狀, Ketamine abuse,psychosomatic symptoms,lower urinary tract symptoms, |
出版年 : | 2019 |
學位: | 碩士 |
摘要: | 背景與目的:愷他命使用會造成多重的健康危害。本研究探討愷他命使用者的使用型態與泌尿道症狀、憂鬱、焦慮等心身症狀之關聯性。
研究方法:於台北市毒品防治中心舉辦中三、四級毒品危害講習的愷他命使用者中,使用自填問卷方式評估使用者之基本資料、愷他命使用型態、透過貝式憂鬱量表(BDI)、簡式健康量表(BSRS)、下泌尿道症狀量表(IPSS)、以及間質性膀胱炎量表(ICSI) 評估受試者的心身科及泌尿科症狀。 研究結果:於2016年11月1日至2017年07月15日,共227位完成有效問卷,其中男性為170人(74.9%),年齡為28.74 6.40,職業分布中,以服務業(38.3%)為最多。首次使用愷他命年齡小於18歲103人(45.4%),18到29歲100人(44.0%),30歲以上24人(10.6%)。愷他命使用期間平均為55.04 49.97月。受試者的下泌尿症狀評分表(IPSS)平均得分為5.283.12分,中度異常(8-15分)共44人(18.1%),重度異常 (>15分)共16人(7.1%)。間質性膀胱炎症狀指標(ICSI)平均得分為2.92 3.11分,其中中度異常 (9-12分)共7人(3.1%),重度異常(>12分)共7人(3.1%)。貝式憂鬱量表(BDI)平均得分為13.565 9.64,其中中度異常(20-28分)共50人(22.0%),重度異常(29-63分)共15人(6.6%)。簡式健康量表(BSRS)平均得分4.79 4.51,中度異常(10-14分)共22人(9.7%),重度異常 (15-20分)共14人(6.2%)。 校正了年齡、性別、初次使用年齡、每日用量之後,愷他命使用時間與下泌尿道症狀指數(correlation factor:0.223, p<0.001)、間質性膀胱炎指數(correlation factor:0.155, p<0.05)、貝式憂鬱量表(correlation factor:0.066, p>0.05)、以及簡式憂鬱量表(correlation factor:0.168, p<0.05)皆呈現正相關。以BDI ≥ 20視為憂鬱困擾,並且在控制年齡與性別後,探討造成憂鬱困擾的風險因子以及其勝算比並且進行邏輯迴歸分析。其中,在下泌尿道症狀分數(IPSS)得分的組別中:正常/輕度(0-8),中度(8-15) 以及重度(>15)之勝算比(95%CI)分別為:1, 3.56(1.43-8.86) (p<0.01),9.48(1.96-46.00) (p<0.01)。 討論與建議:愷他命使用者之泌尿道及心身症狀之比例高,且泌尿道症狀及心身症狀呈現相關,較高的泌尿道症狀也預測了較嚴重的憂鬱症狀,這皆顯示了泌尿道與心身科症狀可能彼此影響,造成個案生理、心理層面的受損。因此,更多的臨床與政策面處遇應即時介入,以提升個案之生活品質,邁向復原之路。 Background: Ketamine use may result in multiple harms over bio-psycho-social aspects. This study aims to investigate the correlations between ketamine use profiles, lower urinary tract symptoms, and psychosomatic symptoms among ketamine users. Method: According to the Law for the Control of Narcotics in Taiwan, ketamine is a class III drug and considered an illegal substance of abuse. Participants of this study will be recruited from the forced education lectures after being arrested by police hours due to illegal ketamine use held by the Taipei City government. Self-administered questionnaires regarding demographic data, ketamine abuse profiles, Beck Depression Inventory, Brief Symptoms of Rating Scales (BSRS), International Prostate Symptoms Scale (IPSS), and Interstitial Cystitis Symptoms Index (ICSI) were delivered. The participants will complete informed consents under approval of the Institute of Review Board of the Taipei City Hospital. Results: A total of 227 participants had completed the investigation within the period from November 1st, 2016 to July 15th , 2017. Among the participants, 170人(74.9%) were male, with the mean age of 28.74 6.40, and main occupation to be in the service industry (38.3%). The history of ketamine use was 55.04 47.97 months while 103 (45.4%) started using ketamine before 18 years old. The IPSS score was 5.28 6.12 while 44(18.1%) and 16 (7.1%) people revealed moderate and severe impairment over lower urinary tract symptoms. The ICSI score was 2.92 3.11 while 7(3.1%) and 7(3.1%) people revealed moderate and severe impairment over interstitial cystitis symptoms. The BDI score was 13.56 9.64 while 50 (22.0%) and 15 (6.6%) revealed moderate to severe impairment over depressive symptoms. The BSRS score was 4.79 4.51 wile 22(9.7%) and 14(6.2%) revealed moderate to severe impairments over depressive symptoms. After adjusting the age, sex, first age of ketamine use and daily amounts, there is a positive correlation between ketamine use durations and IPSS scores (correlation factor:0.223, p<0.001), ICSI scores (correlation factor:0.155, p<0.05), BDI scores (correlation factor:0.168, p>0.05) and BSRS scores (correlation factor:0.168, p<0.05). Within the logistic regression models for prediction of depression (BDI ≥ 20), after adjusting age and sex, an increased odds ratio were noted within the groups with mild (IPSS: 0-8, Odds ratio:1), moderate (IPSS: 8-15, Odds ratio (95%CI): 3.56(1.43-8.86) p<0.01), and severe (IPSS>15, Odds ratio (95%CI): 9.48(1.96-46.00), p<0.01) urinary tract symptoms, prospectively. Discussion: There is a positive correlation between urinary tract symptoms and psychiatric symptoms among ketamine users. Both lower urinary tract symptoms and psychiatric may result in great health hazards and impairment over quality of life. Therefore, further researched regarding on prevention and treatments of urinary and psychiatric symptoms among ketamine users should be addressed. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/21681 |
DOI: | 10.6342/NTU201900941 |
全文授權: | 未授權 |
顯示於系所單位: | 公共衛生碩士學位學程 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-108-1.pdf 目前未授權公開取用 | 16.07 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。