The 20th Congress of RSCANP,

Băile Felix, 18-21.09.2019

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The 42st National Conference of Child and Adolescent Neurology and Psychiatry and Allied Professions with international participation


The cognitive-educational profile of the young user of psychoactive substances

Autor: Cristian Pușcaș Viorel Lupu Ștefan Szamosközi

SUMMARY
Introduction: Conduct disorder in the context of contemporary society is a major public health problem in adolescents, both because of the impact on others and the increased risk of developing other psychiatric distress. The abuse of psychoactive substances in this group has alarmingly increased, educational background being considered as an important factor in the development of this pathology. Objectives: Identifying, in adolescents with conduct disorder, of the correlation between cognitive and educational background and developing substance use in adolescence. Working Hypotheses: Th e main hypothesis of the study assumes a strong relation between cognitive-educational background and occurrence of substance use in adolescents with conduct disorders. The second specifi c hypothesis assumes a relation between academic situation or educational level and occurrence of substance use in adolescents with conduct disorder. A third specifi c hypothesis of these study implies that there is a connection between parental education level and occurrence of substance use in adolescents with conduct disorder. Methods: Th ere have been included 96 patients from the Child and Adolescent Psychiatry and Addiction Clinic – Children’s Emergency Hospital Cluj (46 adolescents who do not used and 50 who used psychoactive substances), aged between 12 – 18, hospitalized with the diagnosis of Conduct Disorder between 01.01.2017 – 30.06.2018. Th e information necessary for the study was taken from the clinic case report forms and aimed at the presence or absence of substance use, adolescent’s IQ level, its academic situation and educational achievements and parental education and occupation level.
Results: After statistical analysis of the collected data, we can conclude that the factor that has the highest role in the onset of substance use is the subject’s intellect, regardless of their academic situation, family status or parental educational level. Keywords: adolescent, conduct disorder, substance use, cognitive-educational family situation, predictive factor.

INTRODUCTION

Conduct disorder in the context of contemporary society is a major public health problem in adolescents, both because of the impact on others and the increased risk of developing other psychiatric distress. The occurence of this psychopathology can be considered a direct consequence of dependence on psychoactive substances [1]. Within this group, psychoactive substance abuse has grown alarmingly, the educational environment being considered an important factor in the development of this pathology [2]. It seeks to identify the most significant factors in the emergence of psychoactive substance use in order to achieve a prototype of the consumer of psychoactive substances, thus facilitating prevention by direct action on the group at highest risk of developing psychoactive substance dependence.

OBJECTIVES
The objective of this study is to identify a correlation between the cognitive and educational background of the family and the occurrence of psychoactive substance use in adolescence. Specifically, it is desirable to identify specific family or adolescent elements, such as those related to educational level, family structure or habitat, and the occurrence of a psychoactive substance addiction in adolescents diagnosed with conduct disorders. WORKING HYPOTHESES The main hypothesis of the study assumes a strong relation between cognitive-educational background and occurrence of substance use in adolescents with conduct disorders. The second specific hypothesis assumes a relation between academic situation or educational level and occurrence of substance use in adolescents with conduct disorder. A third specific hypothesis of these study implies that there is a connection between parental education level and occurrence of substance use in adolescents with conduct disorder.

METHODS
There have been included 96 patients from the Child and Adolescent Psychiatry and Addiction Clinic – Children’s Emergency Hospital Cluj (46 adolescents who do not used and 50 who used psychoactive substances), aged between 12 – 18 (mean 15±1.536), hospitalized with the diagnosis of Conduct Disorder between 01.01.2017 – 30.06.2018. The information necessary for the study was taken from the clinic case report forms and aimed at the presence or absence of substance use, adolescent’s IQ level, its academic situation and educational achievements and parental education and occupation level. After collecting these data, their statistical processing was performed using the SPSS program. All patients who also had other psychiatric pathologies (except conduct disorders (F91.x)), mental and behavioral disorders secondary to the consumption of psychoactive substances (F1x.x), as well as patients under 12 years of age or hospitalized in periods other than the one studied, were excluded from the study.

RESULTS
The results obtained from the statistical analysis were grouped into two broad categories. The first category analyzes subject characteristics, such as the link between the level of intelligence or school situation of the subject and the consumption of psychoactive substances. The second category analyzes the effect of the teenager’s background environment, looking for the link between the mother and father’s educational level, the family situation, the urban or rural background and the occurrence of psychoactive substance use. In order to identify a correlation between the level of cognitive development (IQ) and the occurrence of psychoactive substance use, the T test for independent samples was applied and a close correlation was observed, P = 0.001 CI [-20.161; -5.801]. This revealed a relationship of direct proportionality between the level of cognitive development of the subject and the occurrence of substance use (Table I).

We can conclude that the factor that has the highest role in the onset of substance use is the subject’s intellect (measurable by IQ).

The presence or absence of school abandonment was monitored by school attendance at the time of admission, respectively the presence or absence of repentance, until the time of admission. Using the cHisqared test a correlation between school abandonment and the occurrence of psychoactive substance consumption, respectively between repetence and the occurrence of psychoactive substance use was identified. The results of the statistical analysis showed that the school abandon did not show correlation, P = 0.073 (statistically insignificant), with the consumption of psychoactive substances (Chart 1), but the repentance presents a correlation, P = 0.032 (statistically significant), with the consumption of psychoactive substances (Chart 2).

Five categories of parental education level have been differentiated: from the illiterate, by graduating up to 8 classes, graduating from high school, post-secondary studies, to university studies. We sought a correlation between the educational level of the parents and the occurrence of the consumption of psychoactive substances. By applying the cHi-squared test it was concluded that both the educational level of the mother, P = 0.832 (statistically insignificant), and the father, P = 0.653 (statistically insignificant), does not correlate with the occurrence of psychoactive substance consumption (Chart 3, 4).

We have established five classifications for the patient’s family structure, depending on the person he/she lives with, such as married parents, cohabiting, divorced or single-parent family, abandoned or foster, or with other relatives, statistics have shown that the occurrence of psychoactive substance consumption does not correlate with these aspects (Chart 5).

Analyzing the rural or urban environment of adolescents, we sought a correlation between the habitat and the occurrence of the consumption of psychoactive substances. The statistical analysis shows that the occurrence of psychoactive substance consumption is correlated, P = 0.012 (statistically significant), with the adolescent habitat, with a significantly higher number of adolescents consuming psychoactive substances in the urban environment (Chart 6).

CONCLUSIONS
The results of this study support the hypothesis that there is a link between the IQ of the subject and the occurrence of the consumption of psychoactive substances. These results are supported by the literature [3,4]. The suppositions about the correlation between the educational background and the occurrence of psychoactive substance use have not been supported. In the literature, it is almost unanimously supported that there is an inversely proportionate relationship between the high educational level of parents and the consumption of psychoactive substances among adolescents [2,5]. The only environmental factor that presents a statistically significant correlation with the occurrence of the psychoactive substance consumption is the urban environment. According to the literature, this causality can be explained by the facility of purchasing psychoactive substances in this environment compared to rural areas [5]. In the present study, among the educational factors referring to the subject, only the repentance presents a statistically significant correlation with the occurrence of the consumption of psychoactive substances.
Therefore, the emergence of psychoactive substance consumption may be more likely to reduce school performance and this is followed by repetence. Many studies suggest that students who consume psychoactive substances are at greater risk of school failure, including repetence and school dropout [1]. After analyzing the results of this study, we can conclude that the factor that plays the most important role in the occurrence of psychoactive substance use is the level of intelligence of the subject, regardless of the school situation, the family status or the educational level of the parents. In conclusion we can outline the cognitiveeducational profile of the young consumer of psychoactive substances admitted to the Clinic of Pediatric Psychiatry and Toxicomania in Cluj Napoca, identifying him as having a high cognitive level, coming from the urban environment and with any family substrate.

REFERENCES:
1. DuPont RL, Caldeira KM, DuPont HS, Vincent KB, Shea CL & Arria AM (2013). America’s dropout crisis: Th e unrecognized connection to adolescent substance use. Rockville, MD: Institute for Behavior and Health, Inc. Available at www.ibhinc.org, www.PreventTeenDrugUse.org, and www.cls.umd.edu/docs/ AmerDropoutCrisis.pdf.
2. Denton RE, Kampfe CM, Th e relationship between family variables and adolescent substance abuse: a literature review, Adolescence, 1994 Summer; 29(114):475-95.
3. White JW, Batty GD, Intelligence across childhood in relation to illegal drug use in adulthood: 1970 British Cohort Study, J Epidemiol Community Health doi:10.1136/jech-2011-200252
4. White JW, Gale CR, Batty GD, Intelligence quotient in childhood and the risk of illegal drug use in middle-age: the 1958 National Child Development Survey, Ann Epidemiol. 2012 Sep;22(9):654-7. doi: 10.1016/j.annepidem.2012.06.001. Epub 2012 Jul 7.
5. Jiloha RC, Social and Cultural Aspects of Drug Abuse in Adolescents, Delhi Psychiatry Journal 2009; 12:(2)