Liphihlelo tse sa lebelloang tse sa lebelloang tsa bongoaneng le bothata bo latelang ba ho sebelisa lithethefatsi: thuto ea baahi ba Sweden (1995-2011)

Ho lemalla. Sengoloa se ngotsoeng; e fumaneha ho PMC 2015 Jul 1.

E hatisitsoe ka mokhoa o qetelle o hlophisitsoeng e le:

PMCID: PMC4048632

NIHMSID: NIHMS575230

inahaneloang

Merero

Ho pepesehela boiphihlelo bo makatsang ba ketsahalo e 'ngoe e amoheloang ke kotsi ea ts'ebeliso ea lithethefatsi. Re ikemiselitse ho sekaseka tšusumetso ea likhatello tsa bophelo tse ka fetolang bophelo ba bana, ba nang le boiphihlelo ba bobeli, bothateng ba tšebeliso ea lithethefatsi hamorao sechabeng sa bacha ba Sweden le batho ba baholo ba lilemo (15-26 lilemo tse).

Design

Re entse tlhahlobo ea khatello ea kotsi ea Cox Proportional Hazard, e tlatselletsang lipapiso tse tsamaellanang le balekane ba babeli.

ho ipehela

Sweden

barupeluoa ba

Motho ka mong ho baahi ba Sweden ba hlahetseng 1984 ho 1995, ba neng ba ngolisitsoe Sweden qetellong ea selemo sa almanaka ba fetohela lilemo tsa 14. Nako ea rona ea ho latela (bolela: Lilemo tsa 6.2; lilemo tse Range 11) li qalile selemong seo ba neng ba fetohile 15 mme ba tsoela pele ho fihlela ka December 2011 (N = 1,409,218).

Mehato

Liphetoho tsa rona e bile pherekano ea ts'ebeliso ea lithethefatsi, e khethiloeng ho tsoa litlalehong tsa bongaka tsa bongaka, tsa molao le tsa bongaka. Matšoenyeho a bongoana, joalo ka mokhoa oa DSM-IV oa khatello ea maikutlo, o kenyelletsa ho shoa ha setho sa lelapa le boiphihlelo ba bobeli ba ho sibolla mofets'e o kotsi, kotsi e mpe ea kotsi le ho hlaseloa. Li-covariate tse ling li kenyelletsa tlhalo ea botsoali, bophelo bo botle ba kelello ba lelapa, le mathata a tšebeliso ea lithethefatsi le joala malapeng.

Liphello

Kamora liphetoho tse nkuoang bakeng sa confounders tsohle, batho ba pepesetsoeng lefu la khatello ea bongoa kapa 'tlhaselo ea motsoali' ba bile le menyetla e fetang habeli ea kotsi ea tšebeliso ea lithethefatsi ho feta bao e seng (HR = 2.63 (2.23-3.09) le 2.39 (2.06-2.79 ), ka tatellano).

Nahanisisa

Bana ba tlasa 15 ba hlaheloang ke koluoa ​​e sa tloaelehang (joalo ka motsoali kapa ngoan'eno ea hlekefetsoang, ea fumanoang a na le mofetše, kapa a hlokahala) habeli ba na le monyetla oa ho ba le bothata ba tšebeliso ea lithethefatsi ho feta ba sa e rateng.

Selelekela

Ho pepesehela liketsahalo tse mahlonoko tse makatsang, joalo ka ha ho hlalositsoe ke DSM-](ke hore, ho hlekefetsoa 'meleng le / kapa ho hlekefetsa ka thobalano bongoaneng, ho hlekefetsoa ka thobalano kapa ho loana) ke e' ngoe ea lintlha tse 'maloa tse amoheloang ke kotsi ea tšebeliso ea lithethefatsi (, ). Ho feta 90% ea basebelisi ba lithethefatsi ba tlaleha ketsahalo e le 'ngoe kapa tse ngata tse bohloko bophelong ba bona (, ); Leha ho le joalo, mekhoa ea mokhatlo ona e ntse e sa hlakileng, ka likolo tse tharo tsa mohopolo tse hlaheletseng puong ea tšebeliso ea lithethefatsi. Taba ea mantlha ke hore ho na le hypothesis ea 'ho intlafatsa'), e hlalosang hore ketsahalo e sithabetsang e tla pele ho tšebeliso ea lithethefatsi, ka batho ba seng molaong ba 'ikhethile' ho sebetsana le maikutlo a khatello ea maikutlo a amanang le tsietsi e fetileng. Taba ea bobeli, ke khopolo ea hore tšebeliso ea lithethefatsi e tla pele ketsahalo e bohloko, ea hore tšebeliso ea lithethefatsi ke boitšoaro bo kotsi bo ka lebisang kotsing e kholo ea ho pepesehela likotsi tsa kamoso (-). Qetellong, ke 'artefact hypothesis', mohopolo oa hore litloaelano lipakeng tsa liketsahalo tse mahlonoko le tšebeliso ea lithethefatsi ha li qalelle, li ferekantsoe (kapa ho ba lipakeng) ka mabaka a sa hlakeloang, mohlala., ), kapa lintlha tse arolelanoeng tsa liphatsa tsa lefutso le tikoloho ().

Patlisiso e shebaneng le litlatsetso tsa 'ho iphekola' le 'artefact' e lebisa tlhokomelo e khethehileng ho liphihlelo tse bohloko tsa bongoana (-,, joalo ka ha bana ba nkuoa ba le tlokotsing e kholo ea litšusumetso tse mpe tsa nako e telele tseo mathata a ka bang le tsona boits'ebetsong le liphetho tse tlang (-). Boithuto bo bongata bo fupereng liphihlelo tse bohloko tsa bongoana le psychopathology li sheba haholo likotsi tsa tlhekefetso ea 'meleng le maikutlong, ho se tsotelle le tlhekefetso ea thobalano (mohlala, bona: (, , -)). Bafuputsi ba boetse ba nkile mabaka a tikoloho le a ka 'nang a ba teng ka liphatsa tsa lefutso (joalo ka mathata a tšebeliso ea lithethefatsi tsa motsoali le joala) e le mabaka a ferekanyang a tlhekefetso ea tlhekefetso ea lithethefatsi nakong e tlang (, ).

Leha ho le joalo, lipatlisiso tsa nakong e fetileng li fana ka tlhokomelo e fokolang ho liketsahalo tse ka bitsoang 'liketsahalo tse sa lebelloang' tsa bongoana. Polelo ena ke ea rona ea ho hlalosa liketsahalo tse ka fetohang tsa bophelo ba bongoaneng tse sa arotsoeng e le mefuta ea tlhekefetso kapa ho se tsotelle, e sebetsang le DSM-IV khatello ea khatello ea maikutlo. Liketsahalo tse joalo li arotsoe ka tsela e latelang: i) maikutlong a pelehi 'le matsoho a pele' le ii) a utloa bohloko ka 'matsoho a bobeli', ke hore, ho ithuta ka ho sithabela ho ileng ha etsahala ho setho sa lelapa se haufi (motsoali / ngoan'eso) (, ). Boithuto bona bo tla shebisisa sehlopha sa morao-rao.

Ho tataisoa ke DSM-IV khatello ea khatello ea maikutlo (, ), re bontsitse li-proxies tse 'ne tse nepahetseng bakeng sa boiphihlelo ba bana ba maikutlong ba bobeli bo tsoang ho data ea ngoliso ea Sweden. Tsena li ne li kenyelletsa setho sa lelapa se haufi: i) ho fumanoa o na le mofets'e o bohloko, ii) ho otloa, iii) ho tsoa likotsi tse mpe tsa kotsi tse lebisang ho holofetseng ho sa feleng, le iv) a hlokahala. Re nahana ka maikutlo a hore liphihlelo tsa bobeli tsa khatello ea maikutlo nakong ea bongoana le tsona li khona ho tsosa khatello ea maikutlo, ka hona, li na le monyetla oa ho ama tšebeliso ea lithethefatsi hamorao.

Tšebeliso e fosahetseng ea lithethefatsi hangata e qala lilemong tsa bocha (12-19 ea lilemo tse) (). Bana ba pepesehetseng liphihlelo tse bohloko ba na le kotsi e kholo ea ho sebelisa lithethefatsi tsa pele (). Morero oa thuto ena e nkileng nako e telele e ne e le ho etsa lipatlisiso lipakeng tsa maiphihlelo a bohloko ba ngoana lilemong tsa bobeli (pakeng tsa lilemo tsa 0-14) le ts'ebeliso ea litlahare tsa lithethefatsi nakong e tlang sechabeng sa Sweden le bacha ba baholo (lilemo tsa 15-26) . Ka ho nahana ka ho eketsehileng ka mathata a tšebeliso ea lithethefatsi le joala malapeng, le bophelo bo botle ba kelello, boithuto ba rona bo reretsoe ho leka tlhahlobo ea kelello ea 'ho itlhahisa'), nakong eo ho ntseng ho etsoa lipatlisiso mabapi le hore na ho ba le matsoho a boits'oaro ho ngoana oa bobeli le mathata a ts'ebeliso ea lithethefatsi ke lebaka lefe.

mekhoa

Boloetse ba tšebeliso ea lithethefatsi ke sesosa se hlahisang likotsi tsa liphatsa tsa lefutso, kotsi ea ho ba le mathata a mangata a kantle le lihlahisoa tse ngata tsa kotsi ea tikoloho (). Re sebelisitse mehloli e tšoanang ea data e hlalositsoeng likhatisong tse 'maloa tse fetileng tsa tlhekefetso ea lithethefatsi Sweden (-). Ka bokhutšoanyane re sebelisitse data e hokahaneng ho tsoa ho lingoliso tse ngata tsa Sweden naheng eohle le data ea tlhokomelo ea bophelo bo botle. Ho hokahanya ho fihlelitsoe ka nomoro e ikhethileng ea mananeo a 10 a motho ka mong a abetsoeng tsoalo kapa bojaki ho baahi bohle ba Sweden. Mehloli e latelang e sebelisitsoe ho theha polokelo ea litheko tsa ts'ebeliso ea lithethefatsi: Setsi sa Tsamaiso ea Lipetlele sa Sweden, se nang le lipetlele tsohle ho baahi bohle ba Sweden ba tsoang 1964-2010; Ngoliso ea Bongaka ea Lithethefatsi ea Sweden, e nang le litaelo tsohle tsa Sweden tse nkiloeng ke bakuli ho tloha 2005 ho ea 2009; Rejista ea Tlhokomelo ea Kantle ho nako, e nang le tlhaiso-leseling e tsoang litsing tsohle tsa kokelo ea kantle ho 2001 ho ea 2010; Rejistara ea Tlhokomelo ea Bophelo bo Botle, e nang le lipatlisiso tsa kalafo e tsoang ho 2001-2007 bakeng sa bakuli ba limilione tse 1 ba tsoang Stockholm le Sweden bohareng; Rejista ea Tlolo ea Molao ea Sweden, e nang le data ea naha ho liqoso tsohle ho tsoa 1973-2011; Lenaneo la Sesole la Suspicion la Sweden, le nang le data ea naha ho batho bohle ba belaelloang ka matla tlolo ea molao ho 1998-2011; le Sengoloa sa Lefu la Sweden, se nang le lisosa tsohle tsa lefu.

Ho fapana hoa batho - ho hloka taolo ea lithethefatsi

Re hlokometse linyeoe tsa ts'ebeliso ea lithethefatsi ho tsoa ho lingoliso tsa bongaka tsa Sweden ka ICD dikhoutu: ICD8: ts'ebeliso ea lithethefatsi (304); ICD9: drug psychoses (292) le ts'ebeliso ea lithethefatsi (304); ICD10: mathata a kelello le a boits'oaro ka lebaka la tšebeliso ea litla-morao tsa kelello (F10-F19), ntle le tseo ka lebaka la joala (F10) kapa koae (F17); Rekoteng ea botlokotsebe ka likhoutu: 3070 (ho khanna tlasa ts'usumetso ea li-narcotic), 5010, 5011 le 5012 (ho ba le thepa le tšebeliso ea ntho e seng molaong), le litšupiso tsa melao e koahelang narcotics (molao 1968: 64, serapa sa 1, ntlha 6 (ho ba le, sebelisa kapa liqoso tse ling tse amanang le lintho tse seng molaong) le litlolo tse amanang le lithethefatsi (molao 1951: 649, serapa sa 4, karolwana ea 2 le serapa sa 4A, karolwana ea 2).

Boloetse ba ts'ebeliso ea lithethefatsi bo ile ba bonts'oa hape ho batho ka bomong (ntle le ba nang le lefu la mofets'e) ho Ngoliso ea Bongaka ba Bongaka e neng e khutlisitse (ka kakaretso) litekanyetso tse fetang tse 'ne tse hlalositsoeng tsa letsatsi le letsatsi tsa Hypnotics and Sedatives (Anatomical Therapeutic Chemical (ATC) Classified System N05C le N05BA ) kapa Opioids (ATC: N02A) nako e fetang leshome le metso e 'meli. Boithuto bona bo amohetsoe ka 30th November 2011 ke boto ea tlhahlobo ea melao ea boitšoaro e sebakeng sa Lund, Sweden (Dnr 2011 / 675).

Palo ea batho ba ithutang

Re fumanela batho bohle ba Sweden baahi ba tsoaloang 1984 ho 1995, ba neng ba ngolisitsoe Sweden qetellong ea selemo sa khalendara ba fetohile 14 ea lilemo. Nako ea rona ea ho latela (bolela: lilemo tsa 6.2; lilemo tsa 11) li qalile selemong seo ba neng ba fetohile 15 mme ba tsoela pele ho fihlela selemo sa 2011 (N = 1,409,218).

Li-variables tse ikemetseng

Liphihlelo tse bohloko tse sa lebelloang bongoaneng

Re supile likotsi tse 'ne tsa bongoana tsa bobeli tse sebelisoang bana ICD likhoutu tse tsoang ho Setsi sa Ts'ebetso ea Sepetlele sa Sweden, tse nang le liketsahalo tse joalo tse hlahelang litho tsa lelapa tse haufi tsa mohlala oa rona oa thuto (batsoali / banab'eso ka botlalo - bona sehlomathiso etsoe ICD dikhoutu). Tsena li ne li kenyelletsa ho fumanoa ke mofetše oa mofets'e; ho lemala ka phoso ho lebisang ho holofetseng ho sa feleng (ho lemala ha lesapo la mokokotlo kapa ho senyeha ka botlalo / karolo ea maoto le matsoho); hlaseloa; le lefu.

Taba ea mantlha, re qalile re kopanetse 'boiphihlelo bo bobe bo sa lebelloang ba bongoana' ka ho akaretsa likarabo liketsahalong tsena tse 'ne. Phapang ena e ne e emela tlokotsi e tobileng ho batsoali ba sehlopha sa rona sa ho ithuta feela, eseng banab'abo (1 / 0). Re boetse re thehile dichotomous (1 / 0) tse fapaneng bakeng sa ketsahalo e 'ngoe le e' ngoe ea khatello ea maikutlo mme ra li kopanya ka setho sa lelapa se amehang (motsoali kapa ngoan'eso e mong ka botlalo). Matšoenyeho afe kapa afe a khatello ea bongoana (joalokaha a hlalositsoe ka holimo) a tlameha a be a bile teng ho setho sa lelapa la ha re ntse re ithuta re le 0-14.

Re kenyelelitse tlhalo ea botsoali e le setsi sa boithuto litlhahlobisong tsa rona. Leha tlhalo e sa tšoanelehe joalo ka DSM-IVIV khatello ea maikutlo, lithuto tsa pejana li fumane kamano lipakeng tsa sebopeho sa lelapa le bothata ba tšebeliso ea lithethefatsi (-). Joalokaha ho kopanya lenyalo ntle le lenyalo ho tloaelehile Sweden, re hlalositse selemo sa 'tlhalo' e le selemo seo batho ka bomong ba khaotseng ho lula le batsoali ba bona ka bobeli.

Covariate tse ling tse nkoang e le bong ba batho ba ithutileng, le thuto ea batsoali ba bona, bophelo bo botle ba kelello, mathata a tšebeliso ea lithethefatsi le joala, joalo ka ha ho hlalositsoe ke ICD dikhoutu (, , , ). Har'a bana beso, ke ts'ebeliso ea ts'ebeliso ea lithethefatsi feela (eseng joala) e nkoang e le ntho e ka ferekanyang (). Joalo ka ha lilemo tsa pele tsa ts'oaetso ea ts'ebeliso ea tšebeliso ea tšebeliso ea joala taolong ea rona e ne e le lilemo tsa 41.9, re ile ra nahana hore boitšoaro bo joalo hamorao bophelong bo ne bo tla ba le tšusumetso e nyane kapa e se nang tšusumetso e ngata ho ts'ebeliso ea lithethefatsi tsa bana ba bona lipakeng tsa lilemo tsa 15-24. Ntle le moo, lipatlisiso tsa nakong e fetileng ha li bontše hore ho na le kamano e mpe pakeng tsa ngoan'eno ea nang le tšebeliso e mpe ea tahi ka lebaka la tšebeliso ea lithethefatsi ea ngoan'eno., ).

Re lekantse li-covariate tsohle ha palo ea rona ea ho ithuta e ne e le lilemo tsa 0-14 (bona tse fapaneng tse sa fetoheng litlhaloso le sehlomathiso bakeng sa bohle ICD dikhoutu).

Tlhahlobo ea statistical

Ka lebaka la linako tse fapaneng tsa ho pepeseha ho ipapisitse le selemo le khoeli ea tsoalo, e le hore re hlahlobe litloaelano lipakeng tsa khatello ea bongoana le khatello ea tšebeliso ea lithethefatsi tse latelang, re sebelisitse regx ea Cox Proportional Hazard ho fuputsa batho bohle ho tloha lilemong tsa 15 ho fihlela: i) nako ea pele ngoliso ea bothata ba tšebeliso ea lithethefatsi; ii) ho fihlela lefung; kapa iii) ho fihlela pheletso ea ho latela (selemo sa 2011), ke efe e tlang pele. Ha banab'eso ba botlalo ba ka kenyeletsoa tlhahlobisong, re ile ra ikamahanya le maemo hore e se be boipuso le mohatisi oa sandwich ea matla. Re fuputse khakanyo ea ho lekana mefuteng eohle; haeba sena se sa phethisoe, re kenyelletsa nako ea tšebelisano lipakeng tsa phapang e khahlisang le nako ea logarithm. Re ile ra leka mohopolo oa likotsi tse lekanang bakeng sa mefuta e meng kaofela pele le ka mor'a ho kenyelletsoa ha nako ea puisano. Phapang e kholo ea tlhahlobo eo e bile 'liphihlelo tse mpe tse sa lebelloang tsa bongoana'.

Model 1 e ne e le tlhahlobo e mpe ea "khatello ea bongoana" ea batsoali ba rona ea khatello ea maikutlo. Model 2 e fetotsoe bakeng sa tlhalo ea botsoali, thuto ea botsoali le bong ba palo ea batho bao re ithutang le bona. Model 3 e boetse e ntlafalitsoe bakeng sa liphatsa tsa lefutso tsa motsoali le tikoloho (ka ho sa kenyele batho ba nang le mathata a tšebeliso ea lithethefatsi tsa motsoali le joala, le mathata a kelello a tsoang tlhahlobisong). Model 4 e ntlafalitsoeng haholoanyane bakeng sa lelapa liphatsa tsa lefutso kapa tikoloho hape ka ho qhela batho ba nang le bothata ba tšebeliso e mpe ea lithethefatsi tsa ngoan'eno.

Re entse liteko tse arohaneng ho fuputsa litlamorao tsa e 'ngoe ea likarolo tse' ne tse fapaneng tsa khatello ea maikutlo, li-Models A1a-A1d liketsahalo tse ileng tsa etsahalla batsoali le / kapa banab'eso ba felletseng. Models A2a-A2d e phetetse tekolo ho A1a-A1d, ha e ntse e ikamahanya bohle li-confounders tse ka nahanoang ho Model 4.

Joalo ka tlhahlobo ea maikutlo, ka Sesebelisoa sa Tsoalo se Seholo sa Sweden, re ile ra supa likhaolo tsohle tsa bana ba motho ba babeli ba ngoananang ba nang le bothata ba tšebeliso ea lithethefatsi le boiphihlelo ba rona ba bana ba 'khatello e sa lebelloang ea bana' (motsoala) = 25,522 lipara; N (Bara ba motho ka botlalo) = 5772 lipara). Sena se ne se bolela hore re bapisa bara ba motho ba ngoan'abo ngoan'eso le ngoan'eno moo a le mong (ea lilemo li 0-14) a bileng le khatello ea maikutlo, athe e mong eena ha a ka a hlaha (joalo ka ha a so ka a hlaha ka nako ea ketsahalo ea khatello ea maikutlo, kapa a ba le lilemo tse 15 kapa ho feta) . Mofuta oa likotsi tsa Cox o lekana le motsoala / ngoan'eso ka hona e ikarabella bakeng sa mefuta e mengata e sa tsejoeng ea liphatsa tsa lefutso le tikoloho. Model S1 e fane ka tlhahlobo e se nang kelello; Model S2 e fetotsoe hape bakeng sa tlhalo ea motsoali. Litlhahlobo tsohle tsa lipalo li entsoe ka SAS 9.3 ().

Results

Lethathamo 1 e bonts'a khafetsa le liperesente tsa batho ba ithutileng, ba sithabetseng maikutlo ha e le ngoana oa bobeli, ho bolelang hore o ithutile ho sithabela maikutlo ho setho sa lelapa se haufi. Boemo ba lits'oants'o bo hlahisoa e le i) tekanyo e eketsehang le ii) e le mekhahlelo e arohaneng, sephetho kaofela se hlahisoa ke ho hloka ts'ebeliso ea lithethefatsi. Lethathamo 2 e hlahisa liphetho tsa Models 1-4. Batho ka bomong (ba lilemo tsa 15-26) ho palo ea rona ea ho ithuta, ba pepesitsoeng khatello ea khatello ea bongoana kapa bohareng (pakeng tsa lilemo tsa 0-14 lilemo), ba ne ba le makhetlo a fetang a mabeli ho ngolisoa ka bothata ba tšebeliso ea lithethefatsi (Model 1, HR = 2.12 ( 95% boiketlo ba nako (CI) 1.96-2.30). Kotsi e lekanyelitsoeng e ile ea eketseha kamora phetoho ea thuto ea botsoali le mohlala oa bong ba batho (Model 2, HR = 2.39 (2.16-2.65). Kamora ho lokisoa ha mathata a tšebeliso ea lithethefatsi tsa motsoali le joala, le mathata a kelello (Model 3) le bothata ba motsoala le ngoan'abo ka botlalo (Model 4), kotsi e ka fokotsoang (HR = 1.98 (1.73-2.27) le 1.94 (1.67 -2.25), ka tatellano)). Ho bile le nako ea tšebelisano lipakeng tsa khatello ea maikutlo le bong bo fapaneng ho Model 2 feela (0.87 (0.81-0.94). Khakanyo ea hore e ne e sa phethahale; HR bakeng sa nako ea tšebelisano lipakeng tsa 'nako ea ho kena' le khatello ea khatello ea khatello ea maikutlo e ne e le 0.85 (0.80-0.89) ho Model 1, a fana ka maikutlo a hore phello ea khatello ea khatello ea ts'ebeliso ea ts'ebeliso ea lithethefatsi ea bana e fokotsehile ha nako e ntse e feta.

Lethathamo 1  

Khafetsa le liphesente (%) ea batho ba mohlala ba bileng le boiphihlelo bo sa lebelloang ba bongoana (UACE), bo kentsoeng ke bothata ba tšebeliso ea lithethefatsi (DUD) N = 1,409,218; nako ea ho latela: bolela lilemo tsa 6.2; lilemo tsa 11
Lethathamo 2  

Tekanyetso ea Hazard (HR) e nang le 95% mekhahlelo ea kholiseho (95% CI) ea ts'ebeliso ea litla-morao tsa tšebeliso ea lithethefatsi kamora ho pepesetsoa boiphihlelo bo fapaneng ba "ngoana oa rona ea sa lebelloang ba bongoana" bo fapaneng (UACE) lipakeng tsa lilemo tsa 0-14, le li-covariate tse ling ...

Lethathamo 3 e hlahisa sephetho ho tsoa ho Models A1a-d le A2a-d (litlamorao tsa khatello ea kelello ea ngoana ka mong mabapi le ts'ebeliso ea morao-rao ea lithethefatsi). Kamora ho fetoloa bakeng sa bohle nkoa e le li-confounders (Models A2a-d), mekhahlelo e phahameng ka ho fetisisa ea ba kotsing ea tšebeliso ea lithethefatsi e ne e le lefu le ho hlekefetsoa ke batsoali (HR = 2.63 le 2.39, ka ho latellana), le ho hlekefetsoa ke banab'abo (HR = 1.93).

Lethathamo 3  

Tekanyetso ea Hazard (HR) e nang le 95% mekhahlelo ea kholiseho (95% CI) ea ts'ebeliso ea ts'ebeliso ea lithethefatsi nakong e tlang kamora ho pepesehela ho fapana hoa khatello ea maikutlo (pakeng tsa lilemo tsa 0-14 lilemo le tse ling tse nkuoang e le li-covariates ** (N = 1,409,218)

Tafole 4a 'me And4b4b bonts'a liphetho ho tsoa tlhahlobisong ea maikutlo a bo-motsoala le bana ba motho. Kamora phetoho ea tlhalo ea motsoali (Models S2), kotsi ea kamano ea tšebeliso ea lithethefatsi kamora ho pepesetsoa ketsahalo ea rona ea "bongoana e sa lebelloang ea bana" e ne e le 1.65 bakeng sa motsoala oa pele le 1.46 bakeng sa banab'eso ba felletseng. Kamora ho loanela phapang ea lilemo, kotsi e kholo ka ho fetisisa e ile ea bonoa ho bana bao e leng bo-motsoala / ngoan'abo ngoanana ea felletseng eo phapang ea hae e neng e le kholo ho feta lilemo tsa 5 (bona Tafole 4a-b).

Lethathamo la 4a  

Litekanyetso tsa Hazard (HR) tse nang le 95% mekhahlelo ea kholiseho (95% CI) ea ts'ebeliso ea ts'ebeliso ea lithethefatsi nakong e tlang (DUD) tlhahlobisong ea pele ea joala, ba natefeloa ke boiphihlelo bo bobe bo sa lebelloang ba ngoana (UACE) le DUD (N = 25,522 lipara)
Lethathamo la 4b  

Tekanyetso ea Hazard (HR) e nang le 95% nako ea kholiseho (95% CI) ea ts'ebeliso ea ts'ebeliso ea lithethefatsi nakong e tlang (DUD) tlhahlobisong ea bana ba motho e mong, ba fetoha ba se nang liphihlelo bakeng sa boiphihlelo bo bohloko bo sa lebelloang ba bongoana (UACE) le DUD (N = 5772 lipara)

Puisano

Morero oa thuto ena e nkileng nako e telele e ne e le ho etsa lipatlisiso lipakeng tsa maiphihlelo a bohloko ba ngoana lilemong tsa bobeli (pakeng tsa lilemo tsa 0-14) le ts'ebeliso ea lithethefatsi tsa lithethefatsi selemong sa bocha sa Sweden le bacha ba baholo (lilemo tsa 15-26). Liphetho tsa rona li bonts'a hore batho ka bomong ba neng ba e-na le khatello ea maikutlo ea bongoana, ba ne ba na le kotsi ea tšebeliso ea lithethefatsi habeli ho feta ba neng ba sa e bone. Kamano lipakeng tsa khatello ea rona ea khatello ea maikutlo le tšebeliso ea lithethefatsi e ile ea ananeloa tlhahlobisong ea motsoala le ngoan'abo oa pele (HR = 1.55 (C) 'me 1.46 (S), ka tatellano); leha ho le joalo, ho bo-motsoala / banab'eno bao phapang ea bona e neng e le kholo ho feta lilemo tsa 5, kotsi e lekanang e ile ea lula e le ngata (HR = 1.72 (C) 'me 1.92 (S), ka tatellano). Ho tsebo ea rona, hona ke phuputso ea pele ea naha ka bophara e entseng lipatlisiso tsa litla-morao tsa bana ba bobeli ka mathata a ts'ebeliso ea lithethefatsi, 'me liphetho tsa rona li eketsa bopaki ba bopaki bo supang hore litlamorao tsa malapa li ama kotsi ea ts'ebeliso ea lithethefatsi. bofokoli (, , , , ). Ea mekhahlelo ea khatello ea kelello e hlahlojoang (Lethathamo 3), lefu la motsoali le ne le le kotsing e kholo ea ho sebelisa lithethefatsi (HR = 2.63). Re hlokometse lefu la motsoali ho tsoa ho li-regista tsa lefu tse bakang mafu ohle. Leha ho le joalo, re ne re sa tsebe ho tseba hore na lefu ke sesosa se sa tobang sa mofuta o mong oa koluoa ​​(ke hore, pele ho lefu la kankere e mpe, ho hlaseloa habohloko kapa kotsi e hlahileng).

Ho hlekefetsoa ke motsoali / ngoan'eno ka botlalo ho ne ho amana le kotsi e kaholimo ea kotsi ea tšebeliso ea lithethefatsi hamorao (HR = 4.80 le 4.49, ka tatellano, bona Lethathamo 3). Lits'ebetso tsena li ile tsa hlomphuoa ka mor'a phetoho bakeng sa bohle ba nkoang e le confounders (HR (P) = 2.39, HR (S) = 1.93). Boholo ba ho kenella ka bongata bo ka bonts'a tekanyo ea khokahano lipakeng tsa kotsi ea ho hlaseloa, psychopathology ea mathata a ts'ebeliso ea lithethefatsi, boemo bo bobe ba bophelo ba kelello le maemo a tlase a thuto. Lintho tsena li kanna tsa bonts'a mofuta oa boitšoaro bo iketlileng, bo ka ferekanyang likamano lipakeng tsa ho sithabela ha ngoana oa bobeli le koluoa ​​ea tšebeliso ea lithethefatsi hamorao. Leha ho le joalo, kotsi eo e sala kamora ho fetoha bakeng sa lintlha tsena (le ho tlhahlobisong ea maikutlo a kopaneng), e fana ka ts'ehetso ho maikutlo a hore boiphihlelo ba bobeli ba ho sithabela nakong ea bongoana bo eketsa kotsi ea ho hloka ts'ebeliso ea lithethefatsi bongoaneng / botsofaling.

Ho ba bang bao ho nkoang hore ke banna, ho ba monna e ne e lula e amahanngoa le kotsi e kholo ea tlhekefetso ea tšebeliso ea lithethefatsi (Model 4, Lethathamo 2; HR = 3.32). Sena se tsamaisana le liphumano tse fetileng tsa hore banna ba na le monyetla oa ho leka makhetlo a mabeli ho feta ho basali (le ho its'etleha ka) linthong tse seng molaong., ). Ka mokhoa o ts'oanang, sephetho sa rona se bonts'itse kotsi e atileng ea ts'ebeliso ea lithethefatsi hamorao bophelong haeba ngoana a na le tlhalo ea motsoali (HR = 2.07), e bonts'ang lipatlisiso tsa nakong e fetileng tse etsang lipatlisiso tsa tšebeliso ea lithethefatsi le sebopeho sa lelapa (, -). Leha ho na le lipatlisiso tse ngata tse batlisisang liphihlelo tse bohloko tsa bongoana (mohlala, tlhekefetso ea thobalano kapa 'mele, kapa ho se tsotelle) le boits'oaro bo kotsi bophelong ba kamoso (-, ), ho etsa lipatlisiso ka ho khetheha litlamorao tsa liketsahalo tsa khatello ea letsoho tsa bobeli ho ts'ebeliso ea lithethefatsi ke moferefere. Patlisiso ea PubMed e senotse lithuto tse peli feela tsa ts'ebeliso ea lithethefatsi tse kenyelletsang liketsahalo tse tšoanang tsa khatello ea maikutlo joaloka li-covariate. Lipampiri ka bobeli li tšehelitse litholoana tsa rona ka nepo: Newcomb and Harlow () lihlopha tse etsahalitsoeng ke litlokotsi tse tsoang ho: i) ba lelapa le batsoali, ii) likotsi le bokuli, le iii) phalliso, a ngola liketsahalo tse kang 'liketsahalo tse sa laoleheng tse hatellang'. Ba phethela ka hore liketsahalo tsena li bile le tšusumetso e tobileng le e mahareng ho tšebeliso ea lithethefatsi ho batho ba baholo ba bacha haeba li etsahetse lilemong tsa bocha tsa bohlano (sampole ea lilemo tsa 12-18, N = 376). Thutong ea bobeli ke Reed et al. (), e sebelisitseng tlhaiso-leseling e tsoang ho batho ba baholo ba baholo, joalo ka ha ho hlalositsoe ke DSM-IVIV liketsahalo tsa khatello. Liphetho tsa bona li khothalelitse hore lits'oants'o tsa bophelo ba pele, haeba li tsamaisana le tlhahlobo ea khatello ea maikutlo ka morao ho khatello ea maikutlo (PTSD), li ne li amana le kotsi e eketsehileng ea ts'ebeliso ea lithethefatsi (N = 998).

Ha a leka ho etsa liqeto tse entsoeng ke Reed et al. () (hore likamano lipakeng tsa khatello ea bongoana le tšebeliso ea lithethefatsi li ka tsamaisoa ke tlhahlobo ea PTSD), re boetse ra supa batho bohle ba hlahlobang ba nang le tlhahlobo ea PTSD: i) pakeng tsa lilemo tsa 0-14 (N = 532), le ii) lipakeng tsa lilemo tsa 0-26 (N = 5045) sebelisa likhoutu tsa ICD (ICD10 F43; ICD9 308,309) ho tsoa Ngoliso ea Tsamaiso ea Sepetlele sa Sweden. Kamora ho kenyelletsa batho bana ho tlhahlobisong ea rona, ba nang le khatello ea khatello ea bongoana ba ne ba ntse ba le ka makhetlo a fetang a mabeli ho ngolisoa e le bahlaseli ba lithethefatsi (0-14 lilemo PTSD: HR = 2.17 (1.93-2.35) le 0-26 PTSD: HR = 2.12 (1.92-2.34). Le ha liphetho tsena li sa bonahale li tšehetsa khopolo ea borabele ea Reed et al., Ho lokela ho hlokomeloe hore litefiso tsa PTSD tse tsoang feela ho tsoa litlalehong tsa litšenyehelo tsa sepetlele li kanna tsa ba tlase haholo ho feta tse fumanoeng lipuisanong tse tebileng ().

Taba ea infuse ea Causal e phetoa khang e kholo ho lefu la mafu a tšoaetsanoang (), ba bang ba bile ba pheha khang ea hore, ha ho na tlhaiso-leseling ea tlhahlobo, ho hlaloseha ka mabaka a hlaka. Ha kotsi ea tšebeliso ea lithethefatsi e ntse e phahama ka matla malapeng, bana ba batsoali ba anngoeng ke mathata ba tla arolelana mabaka a tlisoang ke tšebeliso ea lithethefatsi (). Ka hona, ho hiroa ha papiso e kopanetsoeng (e fokotsang palo ea likhaohano tsa tikoloho ha ho bapisoa le batho ba sa ikamahanye le tsona), e ka fana ka ts'ehetso bakeng sa maikutlo a hore likhatello tsa bongoana tse sa lebelloang li kenya letsoho haholo ho aetiology ea ts'ebeliso ea lithethefatsi bophelong hamorao. Joalo ka moelelo oa rona, bo-motsoala / banab'eno ba ka be ba bile le: i) Ha ho mohla nkileng ka ba le ketsahalo ea khatello ea maikutlo (ha e so tsoaloe); kapa ii) o e bone a le lilemo li kaholimo ho lilemo tsa 14; ka hona, ho ka etsahala hore re nyenyefatse kotsi ea tlhekefetso ea tšebeliso ea lithethefatsi litlhahlobisong tsena.

Kotsi ea bothata ba tšebeliso ea lithethefatsi e ne e le matla ho li-probands tse tsamaeang le lilemo tsa bona tse neng li le lilemo tsa 6 kapa ho feta. Sena se ka bakoa ke taba ea hore lipara tsa motsoala / ngoan'eno, eo lilemo tsa bona li neng li sa tšoane ka 5 kapa ka tlase ho moo, e laoloang bakeng sa lintlha tse ngata tsa tikoloho (). Leha ho le joalo, hape ho ka etsahala hore karolo e kholo ea phapang ea likotsi e bonts'a hore na nako ea tlokotsi ea ts'ebeliso ea ts'ebeliso ea lithethefatsi ho qala motsoala e mong le e mong e se e phela.

Matla le Mefokolo

Matla a maholo a thuto ea rona ke mehlala ea selemo le selemo ea sechaba sa 1995-2011 le ho hira mehloli e mengata ea datha ho tšoara linyeoe tsa ts'ebeliso ea lithethefatsi. Lintlha tsa rona li batla li le haufi le 100% bakeng sa bokuli ba tšebeliso ea lithethefatsi le lits'oaetso tsohle tse ling tsa bongaka tse sebelisoang joalo ka boithuto lithutong tsena. Bakeng sa lipetlele tsohle, ke 0.4% feela ea linomoro tsa boitsebahatso ba motho le 0.9% ea lits'oaetso tsohle tsa mantlha tse neng li sa fumanehe. Sena se ile sa re nolofalletsa ho etsa lipatlisiso tsa pele naheng ka bophara ho etsa lipatlisiso ka litlamorao tsa khatello ea maikutlo ea bongoana e sa lebelloang ho ts'ebeliso ea lithethefatsi. Ntle le sena, ho na le meeli e 'maloa ea thuto ea rona e lokelang ho tšohloa le eona.

Re fumane ts'ebetso ea ts'ebeliso ea lithethefatsi ho tsoa litlalehong tsa bongaka, pharmacy le tsa botlokotsebe ICD Likhoutu tsa ho ts'oara linyeoe hara palo ea batho bao re ithutang le bona. Le ha mokhoa ona o na le monyetla oa bohlokoa oa ho se hloke hore motho ea arabang a arabe le ho fana ka tlaleho, kotsi ea khethollo e mpe e ntse e le teng. Ntle le moo, batho ba hapiloeng litlalehong tsa Sweden boholo ba bona e ka ba ba sehlopha se seng se tlase sa batho ba sebelisang lithethefatsi tse matla haholo, bao re reng ke litaba tsa 'tšebeliso ea lithethefatsi.' Leha ho le joalo, lithuto tse entsoeng Norway li tlaleha litekanyetso tsa ts'ebeliso ea lithethefatsi le ho itšetleha ha 3.4%, tse lekiloeng li sebelisa DSM-IIILitekanyetso tsa -R, tse ts'oanang le tse fumanoeng ke thuto ea rona e thehiloeng ho ngolisa (, ).

Leha re ne re tataisoa ke DSM-IV liketsahalo tse bohloko le boits'oaro ba khatello ea maikutlo (ka ho khetheha, ho ithuta ka ho sithabela ho litho tsa lelapa tse haufi) (), re thehile lintho tse fetohileng re ipapisitse le toloko ea rona ea khatello ea maikutlo tse ka bonts'ang habonolo likhoutu tsa ICD ho tsoa litlalehong tsa bongaka. Sena se ile sa etsa hore ho be thata ho netefatsa ho pepesetsoa ha rona maikutlong a bobeli. Leha ho le joalo, re khothatsoa ke tlhahlobo ea kantle ea Ngoliso ea Sepetlele sa Sepetlele sa Sweden, e fanang ka maikutlo a hore boholo ba liphatlalatso li 85-95% e nepahetse ().

Boithuto bona bo ipapisitse le tlhaiso-leseling ea baahi ba Sweden. Ha maemo a tšebeliso ea lithethefatsi Sweden a nkoa a le tlase ha a bapisoa le linaha tse ling tsa Bophirimela, le hore sechaba sa Sweden se na le phihlello ea mahala ho likarolo tse ngata tsa tlhokomelo ea bophelo le ts'ehetso le lisebelisoa, ha ho bonahale habonolo feela hore na liphetho tsee li fetisetsoa joang ho baahi ba bang, bao phihlello ea lisebelisoa tse joalo e lekantsoe.

Qetellong, ha nako ea ho bala e nka lilemo tse leshome le metso e tšeletseng, mekhoa ea lefatše (joalo ka nako le litlamorao tsa bophelo) e kanna ea ba le tšusumetso ho seo re se fumaneng. Leha ho le joalo, tlhahlobo ea morao-rao ea tlhekefetso ea lithethefatsi naheng ea Sweden ka lilemo tse fetang mashome a mane e senotse hore ho tloha 1997-2010, nako le litlamorao tsa bophelo bo botle sepetlele ka lebaka la ts'ebeliso e mpe ea lithethefatsi li lutse li tsitsitse ().

Nahanisisa

Liphetho tsa boithuto bona li bonts'a hore likamano lipakeng tsa liphihlelo tse mpe tse sa lebelloang tsa bongoana le khatello ea tšebeliso ea lithethefatsi hamorao li ntse li le teng, le kamora phetoho ea lelapa mathata a kelello, le mathata a tšebeliso ea lithethefatsi le joala. Ka hona, re ke ke ra hana khopolo-taba ea hore ho ba le nako ea ho pepesehela khatello ea maikutlo bophelong ba bongoana ke sesosa sa bothata ba tšebeliso ea lithethefatsi. Ntle le moo, litholoana tse tsoang ho boiphihlelo bo kopaneng ba maikutlo a rona a kopaneng li hlahisa lipelaelo ka maikutlo a hore likamano pakeng tsa boiphihlelo bo bobe ba bongoana le ho se sebetse ha lithethefatsi ha se lebaka. Motheong oa liphetho tsa rona, leano la hona joale le la nako e tlang le ka una molemo ho feta mererong e mecha ea ho khetholla litho tse sa sireletsehang habonolo tsa sechaba ho hloka ts'ebeliso ea lithethefatsi.

lumela hore baa fokola

Mosebetsi ona o tšehelitsoe ke lithuso tse tsoang ho National Institute of Drug Abuse (R01 DA030005), Lekhotla la Sweden la Lipatlisiso (2012-2378 (le fuoe JS), K2009-70X-15428-05-3 (KS) le K2012-70X-15428 -08-3 (KS)), Lekhotla la Sweden la Ho Sebetsa Bophelo le Lipatlisiso tsa Sechaba (2007-1754: JS; 2013-1836: KS) le Lekhotla la Sweden bakeng sa Tlhahisoleseling ka Joala le Lithethefatsi tse Ling (KS), hammoho le ALF Lithuso tsa lichelete tse tsoang tikolohong ea Skåne li fuoe JS le KS.

sehlomathiso

Liphihlelo tse bohloko tse sa lebelloang tsa bongoana: Likhoutu tsa ICD

Kankere e kotsi

ICD8: 140–49, 150–59, 160–63, 170–74, 180–89, 190–99, 200–09; ICD9: 1400-2089; ICD10: C000-C970.

Bokooa bo sa feleng (Ho lahleheloa ke litho le matsoho ka botlalo)

ICD8 / 9: 887.x, 896.x, 897.x; ICD10: S48.0,1,9, S58.0,1,9, S68.4,8,9, S78.0,1,9, S88.0,1,9, S98.0,4, T13.6, T11.6, T05.1,2,3,4,5,6.

Bokowa bo sa feleng (ho lemala ha lesapo la mokokotlo)

ICD8: 806.x, 958.x; ICD9: 952.x, 806.x; ICD10: S12, S12.1, S12.2, S12.7, S12.9, S14, S14.1, S24, S24.1, S34.0, S34.1, S34.3, G82.x, T06.1, T09.3, T91.1, S91.3, XX SUMNX S22.0.

tlhaselo

ICD8 / 9: E960-E969; ICD10: X850-Y099 Y87.1.

Lintlha tsa tlhaho tsa setho

Boemo ba bophelo ba kelello ba motsoali

ICD8: 295.xx, 296.xx, 298.xx, 297.xx, 299.xx, 300.xx 301.xx; ICD9: 295-316; ICD10: F20–29, F30–39, F50–59, F60–69.

Bothata ba tšebeliso ea joala ba motsoali

ICD8: 291, 980, 571, 303; ICD9: 291, 303, 305A, 357F, 425F, 535D, 571A-D, 980, V79B; ICD10: F10 (ntle le joala bo tahang bo feteletseng: F10.0), Z50.2, Z71.4, E24.4, G31.2, G62.1, G72.1, I42.6, K29.2, K70.0-K70.9, K85.2, K86.0, NXXNNX Likhoutu tsa Anatomical Therapeutic Chemical (ATC) ho ngodiso e hlalositsoeng ea lithethefatsi: disulfiram (N35.4BB51.0), acamprosate (N51.9BB07), kapa naltrexone (N01BB07). Ntle le moo, re bontsitse batho ba nang le bonyane litumelo tse peli tsa ho khanna ho tahoa (molao 03: 07) kapa ba tahiloeng ba ikarabellang sekepeng sa likepe tsa metsing (molao 04: 1951) ho rejista ea Tlolo ea molao. Re sebelisitse sesosa sa Lefu la Lefu ho fumana data ka lefu le amanang le joala 'me re sebelisitse likhoutu tse tšoanang le tse kaholimo.

Khoutu ea tšebeliso ea lithethefatsi ea motsoali / ngoan'eso e felletseng e ne e tšoana le e hlalositsoeng bakeng sa phapang e ts'episitsoeng temeng e kholo.

Mongolo o botlaaseng ba leqephe

 

Phatlalatso ea phaello: Chelete ea thuto ena e fanoe ke NIDA Grant R01 DA030005, Lekhotla la Lipatlisiso la Sweden Grant 2012-2378MH le K2012-70X-15428-08-3, le Lekhotla la Sweden la Working Life le Lits'ebetso tsa Patlo ea Sechaba 2007-1754 le 2013-1836 'mele e sa tsoa boleloa e ne e sena karolo e' ngoe morerong oa ho ithuta; ho bokella, ho sekaseka le ho toloka data; mangolong a tlaleho eo; kapa ka qeto ea ho tlisa pampiri hore e phatlalatsoe.

 

References

1. BRESLAU N, DAVIS GC, SCHULTZ LR. Ho tepella maikutlo ho bang le khatello ea kelello le lefu la nikotine, joala le mathata a mang a lithethefatsi ho batho ba nang le khatello ea maikutlo. Li-Archives tsa General Psychiatry. 2003; 60: 289-294. [E fetotsoe]
2. REYNOLDS M, MEZEY G, CHAPMAN M, et al. Co-morbid post-trauma e sithabetsang khatello ea maikutlo ho sethethefatsi se sebelisang tlhekefetso ea bakuli. Ho Tebella Lithethefatsi le Joala. 2005; 77: 251-258. [E fetotsoe]
3. PEIRCE JM, KOLODNER K, BROONER RK, KIDORF MS. Ketsahalo e sithabetsang Ho pepeseha hoa Basebelisi ba Lithethefatsi. Tlaleho ea Urban Health-Bulletin ea New York Academy of Medicine. 2012; 89: 117-128. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
4. KHANTZIAN EJ. Khopolo-taba ea ho iphekola ea mathata a lemalloang - tsepamisa maikutlo ho ts'epahalo ea heroine le cocaine. Journal ea Amerika ea Psychiatry. 1985; 142: 1259-1264. [E fetotsoe]
5. COTTLER LB, COMPTON WM, MAGER D, SPITZNAGEL EL, JANCA A. Posttraumatic-khatello-khatello ea maikutlo bathong ba sebelisang lithethefatsi ho tsoa ho bongata ka kakaretso. Koranta ea Amerika ea Psychiatry. 1992; 149: 664-670. [E fetotsoe]
6. BROWN PJ, WOLFE J. Ho hlekefetsoa ka tlhekefetso le khatello ea maikutlo ea posttraumatic-khatello ea maikutlo. Ho Tebella Lithethefatsi le Joala. 1994; 35: 51-59. [E fetotsoe]
7. RYB GE, PC ea DisCHINGER, KUFERA JA, BALA KM. Pono le kotsi: Ho tloaelana le boits'oaro bo kotsi le tlhekefetso ea lithethefatsi. Tlhahlobo le Thibelo ea Kotsi. 2006; 38: 567-573. [E fetotsoe]
8. DOUGLAS KR, CHAN G, GELERNTER J, et al. Liketsahalo tse fapaneng tsa bongoana joalo ka lintho tse behang motho kotsing ea ho itšetleha ka lintho: ho ikarola ka nakoana ka maikutlo le mathata a ho tšoenyeha. Mekhoa e Mebetsang ea Ho Sebeka. 2010; 35: 7-13. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
9. LO CC, CHENG TC. Matla a tlhekefetso ea bongoana ho tlhekefetso ea lithethefatsi tsa batho ba baholo. Koranta ea Amerika ea Tšebeliso e Mpe ea Lithethefatsi le Joala. 2007; 33: 139-146. [E fetotsoe]
10. INGLEBY D. Ho falla ho qobelloang le bophelo bo botle ba kelello. New York: Springer; 2005.
11. AndA RF, BROWN DW, FELITTI VJ, et al. Liphihlelo tse fapaneng tsa bongoana le litlhare tse fuoeng tsa psychotropic ho batho ba baholo. Koranta ea Amerika ea Thibelo ea Thibelo. 2007; 32: 389-394. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
12. DUBE SR, FELITTI VJ, DONG M, et al. Tlhekefetso ea bana, ho se tsotelle, le ho se sebetse ka tlung le kotsi ea ts'ebeliso e seng molaong ea lithethefatsi: Phihlelo e bohloko ea bongoana. Lingaka tsa bana. 2003; 111: 564-572. [E fetotsoe]
13. HEFFERNAN K, CLOITRE M, TARDIFF K, et al. Ho sithabela ha bongoana e le mokhoa o sebelisang tšebeliso ea opiate ea bophelo bohle ho bakuli ba mafu a kelello. Mekhoa e Mebetsang ea Ho Sebeka. 2000; 25: 797-803. [E fetotsoe]
14.KENDLER KS, BULIK CM, SILBERG J, le al. Tlhekefetso ea thobalano ea bongoana le mathata a batho ba baholo ba kelello le a ts'ebeliso ea lithethefatsi ho basali - Tlhahlobo ea taolo ea mafu a seoa le Cotwin. Li-Archives tsa General Psychiatry. 2000; 57: 953-959. [E fetotsoe]
15. ROHSENOW DJ, CORBETT R, DEVINE D. Ho hlekefetsoa joaloka bana - tlatsetso e patiloeng ts'ebelisong e mpe ea lithethefatsi. Tlaleho ea Phekolo ea Tlhekefetso ea Lithethefatsi. 1988; 5: 13-18. [E fetotsoe]
16. VANDERKOLK BA, PERRY JC, HERMAN JL. Tšimoloho ea bongoana ea boitšoaro bo kotsi. Koranta ea Amerika ea Psychiatry. 1991; 148: 1665-1671. [E fetotsoe]
17. ANDA RF, FELITTI VJ, BREMNER JD, le al. Liphello tse tšoarellang tsa tlhekefetso le liphihlelo tse bohloko tse amanang le bongoana - Ho kopana ha bopaki bo tsoang ho neurobiology le epidemiology. Li-Archives tsa Europe tsa Psychiatry le Clinical Neuroscience. 2006; 256: 174-186. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
18. FELITTI VJ, AndA RF, NORDENBERG D, et al. Kamano ea tlhekefetso ea bana le ho se sebetse ha malapa ho lisosa tse ngata tse etellang pele tsa lefu ho batho ba baholo -Lithuto tse bohloko tsa bongoana. Koranta ea Amerika ea Thibelo ea Thibelo. 1998; 14: 245-258. [E fetotsoe]
19. FETZNER MG, MCMILLAN KA, SAREEN J, ASMUNDSON GJG. Ho na le setsoalle lipakeng tsa liketsahalo tse bohloko tsa bophelo le tšebeliso e mpe ea joala / ts'ebeliso ea batho ba nang le PTSD? Liphumano ho tsoa sampole ea boemeli ba naha. Ho Tepella Maikutlong le Matšoenyeho. 2011; 28: 632-638. [E fetotsoe]
20. AFIFI TO, HENRIKSEN CA, ASMUNDSON GJG, SAREEN J. Ho hlekefetsoa ha bana bongoaneng le mathata a tšebeliso ea lithethefatsi hara banna le basali mohlaleng oa baemeli ba naha. Koranta ea Canada ea Psychiatry-Revue Canadienne De Psychiatrie. 2012; 57: 677-686. [E fetotsoe]
21. NELSON EC, HEATH AC, LYNSKEY MT, et al. Tlhekefetso ea bana ho tsa thobalano le likotsi tsa litlamorao le litlamorao tse tlisoang ke lithethefatsi: thuto ea mafahla. Phekolo ea kelello. 2006; 36: 1473-1483. [E fetotsoe]
22. BRESLAU N, WILCOX HC, STORR CL, et al. Ho pepesetsoa ke ho sithabela maikutlong le ho sithabela ha maikutlo ka mor'a ho pepa: Tlhahlobo ea bacha ba Amerika litoropong. Tlaleho ea Urban Health-Bulletin ea New York Academy of Medicine. 2004; 81: 530-544. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
23. BRESLAU N, KESSLER RC, CHILCOAT HD, et al. Ho sithabela ha khatello ea maikutlo le ho kula seterekeng: 1996 Detroit Area Survey of Trauma. Li-Archives tsa General Psychiatry. 1998; 55: 626-32. [E fetotsoe]
24. HOVDESTAD WE, TONMYR L, WEKERLE C, THORNTON T. Hobaneng tlolo ea bongoana e hokahane le tlhekefetso ea bongoana? Tlhahlobo e Bohlokoa ea Mehlala e Hlalosang. Koranta ea Machaba ea Bophelo bo Botle ba Kelello le Bokhoba ba Tabo. 2011; 9: 525-542.
25. TONMYR L, THORNTON T, DRACA J, WEKERLE C. Tlhahlobo ea tlhekefetso ea bana le kamano ea tlhekefetso ea bongoana. Tlhahlobo ea hona joale ea Psychiki. 2010; 6: 223-234.
26. KENDLER KS, SUNDQUIST K, OHLSSON H, et al. Litšusumetso tsa liphatsa tsa lefutso le tsa malapa le tikoloho ka Kotsi ea Ts'ebeliso e Mpe ea Lithethefatsi: Thutong ea Naha ea Sweden. Li-Archives tsa General Psychiatry. 2012; 69: 690-697. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
27. KENDLER KS, OHLSSON H, SUNDQUIST K, SUNDQUIST J. Tšusumetso ea tikoloho mabapi le tšebeliso e mpe ea lithethefatsi litulong tsa bana ba motho oa pele: thuto ea naha ea Sweden. Phekolo ea kelello. 2013; 23: 1-9. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
28. KENDLER KS, OHLSSON H, SUNDQUIST K, SUNDQUIST J. Tlhahlobo ea morao-rao ea tlhekefetso ea lithethefatsi sampoleng ea naha ea Sweden. Phekolo ea kelello. 2013; 1: 1-10. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
29. MANDARA J, ROGERS SY, ZINBARG RE. Litlamorao tsa Moralo oa Lelapa ho Ts'ebeliso ea Marijuana ea Amerika. Tlaleho ea Lenyalo le Lelapa. 2011; 73: 557-569.
30. SUH T, SCHUTZ CG, JOHANSON CE. Sebopeho sa lelapa le ho qala ts'ebeliso ea lithethefatsi tse seng tsa bongaka har'a bacha. Journal ea Tlhekefetso ea Lithethefatsi le Bana. 1996; 5: 21-36.
31. HOFFMANN JP, JOHNSON RA. Setšoantšo sa naha sa sebopeho sa malapa le tšebeliso ea lithethefatsi tsa bongoaneng. Sengoloa sa Lenyalo le Lelapa. 1998; 60: 633-645.
32. SAKYI KS, MELCHIOR M, CHOLLET A, SURKAN PJ. Litlamorao tse kopaneng tsa tlhalo ea botsoali le nalane ea botsoali ea khatello ea maikutlo mabapi le ts'ebeliso ea cannabis ho batho ba baholo ba Fora. Ho Tebella Lithethefatsi le Joala. 2012; 126: 195-199. [E fetotsoe]
33. JOHNSON JL, LEFF M. Bana ba basebelisi ba lithethefatsi: Kakaretso ea liphetho tsa lipatlisiso. Lingaka tsa bana. 1999; 103: 1085-1099. [E fetotsoe]
34. KENDLER KS, OHLSSON H, SUNDQUIST K, SUNDQUIST J. Kahare ho Lelapa Phetisetso ea Tlhekefetso ea Lithethefatsi: Thutong ea Naha ea Sweden. JAMA Psychiatry. 2013; 70: 235-42. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
35. BIERUT LJ, DINWIDDIE SH, TSOHLE H, et al. Ho fetisoa hoa lelapa ka ts'ebeliso ea lino tse tahang: joala, matekoane, koae le ho tsuba tloaelo: tlaleho e tsoang ho Collaborative Study on the Genetics of Alcoholism. Li-Archives tsa General Psychiatry. 1998; 55: 982-8. [E fetotsoe]
36. MERIKANGAS KR, STOLAR M, STEVENS DE, et al. Phetisetso ea lelapa ea mathata a tšebeliso ea lithethefatsi. Li-Archives tsa General Psychiatry. 1998; 55: 973-9. [E fetotsoe]
37. SAS INSTITUTE INC. SAS ONLINE DOC Version 9.3. Cary, NC: SAS Institute Inc; 2008.
38. NEEDLE RH, SU SS, DOHERTY WJ. Tlhalo, ho nyala hape, le ts'ebeliso ea lithethefatsi tsa bocha - thuto ea nako e telele e lebelloang. Journal ea Lenyalo le Lelapa. 1990; 52: 157-169.
39. WARNER LA, KESSLER RC, HUGHES M, ANTHONY JC, NELSON CB. Bokapele le lintho tse amanang le tšebeliso ea lithethefatsi le ho itšetleha ka United States-liteko tse tsoang ho National Comorbidity Survey. Li-Archives tsa General Psychiatry. 1995; 52: 219-229. [E fetotsoe]
40. GREENFIELD SF, MANWANI SG, NARGISO JE. Epidemiology ea mathata a ts'ebeliso ea lithethefatsi ho basali. Li-Clinic tsa maiketsetso le tsa bongaka ba mafu a basali tsa Amerika Leboea. 2003; 30: 413-46. [E fetotsoe]
41. BRADY KT, BORA SE. Ho sithabela ha bongoana, ho sithabela ha khatello ea maikutlo le khatello ea tahi. Patlisiso ea Joala-Litlhahlobo tsa hajoale. 2012; 34: 408-413. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
42. NEWCOMB MD, TSOANG LL. Liketsahalo tsa bophelo le ts'ebeliso ea lithethefatsi har'a bacha - litlamorao tsa ho lemoha tahlehelo ea taolo le ho hloka moelelo bophelong. Journal ea Botho le Psychology ea Sechaba. 1986; 51: 564-577. [E fetotsoe]
43. REED PL, ANTHONY JC, BRESLAU N. Ketsahalo ea mathata a lithethefatsi ho batho ba baholo ba pepesitsoeng ke khatello ea maikutlo le khatello ea maikutlo ea Posttraumatic - Na liphihlelo tsa bophelo ba bonyaneng le litokisetso li bohlokoa? Li-Archives tsa General Psychiatry. 2007; 64: 1435-1442. [E fetotsoe]
44. ROTHMAN KJ, GREENLAND S, POOLE C, LASH TL. Sesosa le sesosa sa ho baka. Ka: Rothman KJ, Greenland S, Lash TL, bahlophisi. Epidemiology ea Kajeno. Philadelphia, PA: Lippincott Williams & Wilkins; 2008. maq. 5-31.
45. HIBELL B, GUTTORMSSON U, AHLSTROM S, et al. Tlaleho ea 2007 ESPAD: Ts'ebeliso ea Lithethefatsi Har'a Baithuti ho linaha tsa Europe tsa 35. Lekhotla la Sweden la Tlhahisoleseling ka Joala le Lithethefatsi tse Ling (CAN); 2007.
46. KRAUS L, AUGUSTIN R, FRISCHER M, et al. Ho hakanyetsa ho ata ha tšebeliso ea lithethefatsi maemong a naha ho linaha tsa European Union le Norway. Ho lemalla. 2003; 98: 471-485. [E fetotsoe]
47. LUDVIGSSON JF, ANDERSSON E, EKBOM A, et al. Tlhahlobo le kantle ho tumello ea ngoliso ea molao ea naha ea Sweden. Bophelo bo Botle ba BMC. 2011; 11: 1471-2458. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
48. GIORDANO GN, OHLSSON H, KENDLER KS, et al. Nako ea lilemo, nako le mekhoa e hloahloa ea ho sebelisa ts'ebeliso e mpe ea lithethefatsi kahare ho palo e felletseng ea sechaba sa Sweden (1975-2010) Ts'ebeliso ea lithethefatsi le joala. 2013; 19 Epub pele e hatisoa. [Tlhahiso ea mahala ea PMC] [E fetotsoe]