Ludzkie koronawirusy - autor: Krzysztof Pyrć z Zakładu Mikrobiologii, Wydział Biochemii, Biofizyki i Biotechnologii, Uniwersytet Jagielloński, Kraków

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© Borgis - Postępy Nauk Medycznych 12/2011, s. 1025-1031
*Monika Grzelczyk-Wielgórska1,2, Teresa Jackowska1,2, Marcin Wojnar3, Bartosz Szulc2, Julita Wojnar3
Using alcohol or other psychoactive substances, and the occurrence of risky behaviors in adolescents, based on own material**
Using alcohol or other psychoactive substances, and the occurrence of risky behaviors in adolescents, based on own material**
1Department of Pediatrics, Medical Center for Postgraduate Education, Warsaw, Poland
Head of Department: prof. Teresa Jackowska, MD, PhD
2Clinical Department of Pediatrics, Bielanski Hospital, Warsaw, Poland
Head of Department: prof. Teresa Jackowska, MD, PhD
3Department of Psychiatry, Medical University of Warsaw, Poland
Head of Department: prof. Marcin Wojnar, MD, PhD
Streszczenie
Wstęp. Z najnowszych badań prowadzonych na świecie wynika, że wzrasta rozpowszechnienie spożywania alkoholu i substancji psychoaktywnych wśród młodzieży. Problem ten dotyka również młodych dorosłych w Polsce.
Cel pracy. (1) Ocena częstości i uwarunkowań spożywania alkoholu i innych substancji psychoaktywnych oraz zachowań ryzykownych wśród młodzieży w wieku 13-18 lat. (2) Zbadanie czynników wpływających na spożywanie substancji psychoaktywnych.
Materiał i metody. Badaniem ankietowym objęto młodzież w wieku 13-18 lat zgłaszającą się do izby przyjęć lub przebywającą na oddziale z powodu różnych przyczyn, w latach 2009-2010.
Wyniki. Do badania włączono 125 pacjentów: 52 (41,6%) chłopców i 73 (58,4%) dziewcząt. Średnia wieku badanych wynosiła 15,5 lat. Spośród badanej grupy dzieci 80 (63,7%) zadeklarowało, że piło alkohol. Paliło lub pali papierosy 62 (49,2%), z czego 22 (17,7%) pali codziennie. Paliło w swoim życiu marihuanę 29 (23,4%) dzieci. Dziewięcioro (7,3%) używało kokainy; czworo (3,2%) wąchało klej lub inne rozpuszczalniki; 9 (7,3%) używało innych narkotyków tj. LSD, amfetamina, extasy itp.; 20 (16,3%) bez zaleceń lekarza zażywało leki sprzedawane w aptece bez recepty; 9 (7,3%) zadeklarowało zażywanie dopalaczy; 39 (31,2%) przebadanych nastolatków odbyło stosunek seksualny.
Wnioski. Spożywanie alkoholu i zażywanie substancji psychoaktywnych jest istotnym problemem w okresie dojrzewania. Wyniki ankiety wskazują na bezwzględne rozszerzenie profilaktyki w szkołach i ośrodkach dla młodzieży, mówiącej o szkodliwym działaniu alkoholu i substancji psychoaktywnych. Rodzina i grupa rówieśników ma decydujący wpływ na zachowania ryzykowne u dzieci i młodzieży.
Summary
Intoduction. The latest worldwide research shows an increase in the consumption of alcohol and using psychoactive substances among adolescents. This problem also affects young adults in Poland.
Aim of study. (1) To evaluate of the frequency and of factors which contribute to consuming alcohol or other psychoactive substances, and the occurrence of risky behaviors among adolescents aged 13-18 years. (2) To examine the factors affecting the consumption of psychoactive substances.
Material and methods. Adolescents aged 13-18 coming to the Emergency Room or hospitalized at the Pediatric Department in the years 2009-2010 were asked to fill in a questionnaire.
Results. The study included 125 patients: 52 (41.6%) boys and 73 (58.4%) girls. The average age of the respondents was 15.5 years. Out of the above group, 80 (63.7%) young people declared to have drunk alcohol. 62 (49.2%) of them smoke or have smoked cigarettes, and 22 (17.7%) smoke every day. 29 (23.4%) children have smoked marijuana in their lives. 9 (7.3%) have used cocaine, 4 (3.2%) have sniffed glue or other solvents, while 9 (7.3%) have used other drugs, such as LSD, amphetamines, ecstasy, etc.; 20 (16.3%) have used drugs sold at pharmacies without a prescription, without doctor’s instructions; 9 (7.3%) declared to have used highs, and 39 (31.2%) respondents have had sexual intercourse.
Conclusions. Alcohol consumption and using psychoactive substances is a significant problem in the period of adolescence. Survey results indicate the absolute necessity of extending prophylaxis, speaking about the harmful effects of alcohol and psychoactive substances at schools and youth centers. The family and peer groups have a decisive impact on risk behaviors in children and adolescents.
Introduction
Alcohol and psychoactive substance consumption is a serious problem among young people. Adolescence is a time when risky and inconsiderate decisions are common. It is also a time when various changes happen in a young person’s life, e.g. a change of school and a change of the community, and these situations significantly increase the risk of drinking alcohol and taking other psychoactive substances bring about apparent sense of happiness and detachment from the problems (1).
The scale of this phenomenon is difficult to estimate, as not all young people who have drunk alcohol or taken other psychoactive substances admitted having done it, when asked.
The aim of the study performed at the Department of Pediatrics, Bielanski Hospital in Warsaw, was to evaluate the frequency and the determinants of drinking alcohol and using other psychoactive substances, and the occurrence of risky behaviors among adolescents aged 13-18 years. The research also aimed to indicate what factors influence the frequency of the consumption of psychoactive substances, and how often they become a cause of intoxication and hospitalization.
Material and methods
Young people 13-18 years old admitted at the Emergency Room or hospitalized at the Clinical Department of Pediatrics, Bielanski Hospital in Warsaw for various reasons (infections, allergic reactions, headaches, stomachaches, psychoactive substance intoxications, planned diagnostics) were included in the study. The inclusion criterion was getting a written agreement to participate in the study from the parents and the child (up 16 years old). The exclusion criteria were: severe injury requiring an immediate treatment, a traumatic psychic condition (attempted suicide, suspicion of sexual abuse), need of hospitalization at the Psychiatric Ward and a lack of possibility of getting a written consent from the caregivers or child (handicapped persons).
Patients and their parents were informed about the aim and course of the study and that their participation had no impact on the progress of the treatment. The agreement was confidential, and it was collected and stored separately, independently of the questionnaire so that the study would remain anonymous.
The questionnaire was anonymous, and the participants threw the filled form into a specially prepared, closed box. It contained questions concerning demographic data, the participant’s physical and mental health, alcohol, psychoactive substance use, other risky behaviors, existing injuries and health status, social and school activities of the participant interviewed, parental care and parental abuse of alcohol or psychoactive substances.
The questions were taken and translated from surveys used worldwide. Such tools are widely available in the literature and do not require additional permission of the authors to use them.
Processing of the results based on the multivariate logit model.
1. The following variables were taken into account:
– the dependent variables
– drinking alcohol
– smoking
– smoking marijuana
– sniffing glue and/or solvents
– use of cocaine
– use of drugs such as LSD, PCP, hallucinogenic mushrooms, amphetamine, methamphetamine, heroin, extasy and others
– use of OTC medicines with potentially psychogenic effects: dextromethorphan (Acodin, Tussal), metylomorfin (Codeine), Tramadol, Paracetamol, ephedrine (Tussipect) and other
– use of highs/designer drugs
2. Independent variables:
– socioeconomic status of the family (use of welfare depressed mood)
– suicidal thoughts and attempts
– participation in religious ceremonies
– participation in extracurricular activities at school (cheerleading, student council)
– participation in activities outside of school (clubs, circles of interest, scouting, sports, dance classes, etc.),
– drinking alcohol by friends
– parents’ interest in the life of the child, and clearly set rules within the family,
– alcohol consumption, smoking and drug use by parents
– repeating a class
Results
The study included 125 children and adolescents: 52 (41.6%) boys and 73 (58.4%) girls, aged 13-18 years (average 15.5 years). 80 (63.7%) children out of the total said they had drunk alcohol.
To the question:
1. How often have you been drinking alcohol in the last 12 months?
16 people (12.9%) responded that at least once a week, while 45 (36.3%) had never consumed alcohol in the last year. Detailed responses are shown in figure 1.
Fig. 1. Frequency of drinking alcohol in the last 12 months.
In order to determine the amount of alcohol drunk at one time, 1 drink was defined as a standard portion of: 200 g of beer, 10% – wine 100 g, 25 g of 40% vodka.
Forty (46%) people declared to have drunk at once 1-2 drinks, 15 (17.2%) 3-4 drinks, 12 (13.8%) 5-6 drinks, 6 (6.9%) of them drank 7-9 drinks, and as many as 14 young people (16.1%) had 10 or more drinks (fig. 2). Five or more drinks (the amount sufficient for an intoxication), had been drunk at once by 27.6% of the children. Fifty (40.6%) people said they had drunk that alcohol to relax, improve their mood or fit into the company. As many as 21 (17.1%) young people drank alcohol alone, and 28 (23.1%) did not remember hat happened after drinking the alcohol.
Fig. 2. Number of drinks drunk at once during the incident that brought them to hospital.
The multivariate logit model was used to identify the factors that contribute to reaching for alcohol. Indeed, young people whose friends and acquaintances drank and who declared in the questionnaire a depressed mood and less psychological comfort, drank statistically significantly more frequently. And in turn, the respomdents who turned to alcohol significantly less frequently were those whose parents were more interested in their lives and leisure activities (asked with whom and where they were going, when they would be back, about their homework) and in families where the rules were clearly defined. Other factors, such as the family’s socioeconomic status, suicidal thoughts and attempts, participation in religious ceremonies, active participation in extracurricular activities at school and outside school, parental addictions or repeating the class had no statistically significant effect on the frequency of drinking alcohol.
Other risky behaviours included in the questionnaire were:
2. Do you smoke?
22 (17.7%) respondents admitted that they smoked cigarettes every day, while 63 (50.8%) had never smoked. The rest smoked occasionally, with varying frequencies (fig. 3). Young people taking an active part in extracurricular activities outside their school (dance classes, scouting, clubs, etc), as well as those who repeated the class at school, and whose colleagues and friends drank alcohol – smoked cigarettes more often. However, those who participating in extracurricular activities within their school (circles of interest, meetings, sports activities) smoked less frequently. Other factors listed as the independent variables had no significant effect on the occurrence of smoking.
Fig. 3. Frequency of smoking cigarettes.

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Piśmiennictwo
1. Bobrowski K: Używanie substancji psychoaktywnych i inne zachowania problemowe młodzieży gimnazjalnej. Zmiany pomiędzy 14. a 16. rokiem życia. Alkoholizm i Narkomania 2005; 18 (1-2): 27-38.
2. Sierosławski J: Używanie alkoholu i narkotyków przez młodzież szkolną. Raport z ogólnopolskich badań ankietowych zrealizowanych w 2007 roku. Europejski program badań ankietowych w szkole ESPAD. http://www.parpa.pl/download/Raport%20ESPAD%202007%20Polska1.pdf
3. Wells JE, Horwood LJ, Fergusson DM: Drinking patterns in mid-adolescence and psychosocial outcomes in late adolescence and early adulthood. Addiction 2004; 99 (12): 529-41.
4. Elder RW, Shults RA, Swahn MH et al.: Alcohol-related emergency department visits among people aged 13 to 25 years. J Stud Alcohol 2004; 65 (3): 297-300.
5. Hawkins JD, Catalano RF, Miller JY: Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychological Bulletin 1992; 112 (1): 64-105.
otrzymano: 2011-10-05
zaakceptowano do druku: 2011-11-10

Adres do korespondencji:
*Monika Grzelczyk-Wielgórska
Klinika Pediatrii Centrum Medyczne Kształcenia Podyplomowego
ul. Marymoncka 99/103, 01-813 Warszawa
tel.: (22) 864-11-67
e-mail: mgrzel@yahoo.com

Postępy Nauk Medycznych 12/2011
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