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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳為堅(Wei J. Chen) | |
dc.contributor.author | Hao-Yuan Yang | en |
dc.contributor.author | 楊皓媛 | zh_TW |
dc.date.accessioned | 2021-06-17T08:06:56Z | - |
dc.date.available | 2022-12-31 | |
dc.date.copyright | 2019-08-27 | |
dc.date.issued | 2019 | |
dc.date.submitted | 2019-08-19 | |
dc.identifier.citation | References
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/73621 | - |
dc.description.abstract | 背景
愷他命係一作用於Glutamertergic N-methyl- d-aspartate (NMDA) 受器之非競爭拮抗劑,為一種非鴉片系麻醉藥物。最初在1960年代越戰時期被用於人類身上,然而過去二十年來大量報告指出愷他命在世界各地被作為娛樂性使用的比例顯著地上升,特別在東亞及東南亞地區。而在台灣從民國98年起愷他命在常見的非法藥物中使用頻率排名第二,於民國103年時終生盛行率為0.39%。先前的研究指出愷他命的濫用導致的精神病症狀超過其半衰期的時間。一台灣研究指出,比較精神病症狀的嚴重程度,發現未出現精神病症狀的愷他命使用者比起愷他命使用者伴隨著持續的精神病症狀,前者有較低的正性分數;而這兩組和思覺失調症患者相比,思覺失調症患者有最高的正性分數。然而娛樂性地使用愷他命是否會導致精神病的風險上升是尚未被調查的,因此本研究旨在檢驗相比於對應的性別及年齡層的一般族群,愷他命初犯者在被捕後三年內是否會增加尋求精神病住院治療的風險。 方法 愷他命使用者來自三、四級行政裁罰系統,且為限縮為愷他命初犯者,我們進一步將三、四級行政裁罰系統與與記載著一、二級毒品犯罪紀錄的刑案紀錄表做連結,留下愷他命初犯者為我們的研究族群。此外,為計算愷他命初犯者的精神病標準住院率,我們將其與全民健保資料庫的住院檔做連結;另外,我們也與全國死因檔連結作為人年上的計算。 結果 民國99年至102年25068名年齡在18-69歲間的愷他命初犯者中有20403名為男性 (81%) ,和一般人口相比愷他命初犯者整體的精神病標準化住院率為2.6,我們進一步將其分層被捕前一年有無精神病的住院紀錄,發現在被捕前一年有精神病的住院紀錄的族群後續在被捕後三年內又因精神病而住院的比例大幅增加 (標準化住院率: 整體: 26.7; 男性: 24.0; 女性: 36.4) 結論 娛樂性使用愷他命會增加尋求精神病住院治療的風險,另外愷他命初犯者使用精神病住院治療的比例上升可能潛在地說明了愷他命的濫用會誘發精神病。 | zh_TW |
dc.description.abstract | BACKGROUND: Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, which was synthesized as a dissociative anesthetic in the 1960s and was first used in humans during Vietnam War. Reports have indicated that ketamine has been used recreationally in many areas of the world over the past two decades. In Taiwan, ketamine has been the second most frequently used illicit drug since 2009, with a lifetime prevalence of 0.39% in 2014. Previous studies have showed ketamine abusers develop psychotic symptoms that persist far beyond the period of intoxication. Comparing the severity of psychotic symptoms, treatment-seeking non-psychotic ketamine users were found to have lower positive scores than ketamine users with persistent psychosis, whereas both groups had lower scores as compared to schizophrenia patients in a psychiatric center in Taiwan. However, whether recreational use of ketamine could lead to increased risk for psychosis has not been investigated. This study aimed to examine whether seeking treatment for psychosis increased among first-time ketamine offenders after their arrest as compared to the general population.
METHODS: Ketamine drug offenders were identified from Administrative Penalty system for Schedule III/IV Illegal Drugs” (APS_3-4), which was launched in 2009. To exclude those offenders who might use narcotics before, we linked the database APS_3-4 with Criminal Record Processing System” (CRPS) that contain information about previous drug offenders, and retained only first-time ketamine offenders. To investigate medical utilization, we further linked APS_3-4 with the inpatient claims records in the National Health Insurance Research Database. In addition, National Mortality Database was used to estimate individual who censored by competitive death. Then we estimated standardized admission ratio for psychosis within 3 years of first-time ketamine offenders during the period of 2010 to 2013. RESULTS: From 2010 to 2013, a total of 25068 first-time ketamine offenders aged 18 to 69 were identified from the two national drug offense databases, with 20403 (81%) of them being male. Compared to the general population, the overall standardized admission ratio (SAR) of inpatient treatment for psychosis was 2.6 for the cohort of 2010 to 2013. When stratified by the experience of inpatient treatment for psychosis within 1 year prior to the first arrest, there was a large increase in SAR among individuals who had inpatient treatment records for psychosis within 1 year prior to arrest (24.0 for males, 36.4 for females, and 26.7 for total). CONCLUSION: The results indicated that recreational use of ketamine indeed increased the risk for psychosis treatment. And the increased of inpatient service utilization for first-time ketamine offenders with psychosis may reveals that using ketamine could potentially induce psychosis. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T08:06:56Z (GMT). No. of bitstreams: 1 ntu-108-R06849028-1.pdf: 771314 bytes, checksum: 111e7ad8a4b3a8b73bdb115625ab2004 (MD5) Previous issue date: 2019 | en |
dc.description.tableofcontents | 摘要 i
Abstract iii Chapter 1 Introduction 6 Chapter 2 Methods 9 2.1 Study sample and data source 9 2.2 Outcome definition 10 2.3 Statistical analysis 11 Chapter 3 Results 12 Chapter 4 Discussion 14 References 16 | |
dc.language.iso | en | |
dc.title | 愷他命娛樂性使用與住院治療精神病:2010至2013年愷他命初犯者全國性世代的三年追蹤研究 | zh_TW |
dc.title | Recreational use of ketamine and hospitalization for treating psychosis: A 3-year follow-up study of national cohorts of first-time ketamine offenders from 2010 to 2013 | en |
dc.type | Thesis | |
dc.date.schoolyear | 107-1 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 陳亮妤,陳志根,張書森 | |
dc.subject.keyword | 愷他命、精神病、住院使用、娛樂性使用, | zh_TW |
dc.subject.keyword | Ketamine, psychosis, hospitalization, recreational use, | en |
dc.relation.page | 22 | |
dc.identifier.doi | 10.6342/NTU201903967 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2019-08-19 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 流行病學與預防醫學研究所 | zh_TW |
顯示於系所單位: | 流行病學與預防醫學研究所 |
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