愈早使用非法物質與愈早違法的影響？—台灣男性青少年罪犯精神健康影響之研究

Do Earlier Age of Initiation of Substance Use and Criminal Behavior Matter? Survey of Mental Health Problems among Taiwanese Male Juvenile Delinquents

目的：本文主要探討台灣男性青少年罪犯中，較早使用非法物質與犯行，與現有非法物質使用、犯行及精神疾病共病性之關聯性。方法：以北台灣某少年矯正機構中一年內所有曾經使用非法物質的新進個案為樣本，最後52名完成兩階段的評估，包括填寫自陳式問卷、中文版K-SADS-E之診斷性會談。依個案在15歲之前初次使用非法物質和犯罪的記錄分成三組來檢測與現有犯罪行為、精神疾病共病性的相關性。結果：所有的男性青少年罪犯，較早使用非法物質與違法的族群在各項物質使用的年齡皆顯著較低(p<0.05)。校正年齡因素後，所有的男性青少年罪犯逐年有明顯的較高機會罹患非法藥物使用疾患（可能性比率[oddration,OR]=2.07，95%信效區間[condenceinterval,CI]=1.19-3.61，p<0.01）；明顯的較大機會使用搖頭丸(OR=1.62,95%CI=1.05-2.60,p<0.05)、大麻(OR=1.69,95%CI=1.07-2.68,p<0.05)和安非他命(OR=1.57,95%CI=1.02-2.42,p<0.05)。結論：本研究發現所有的男性青少年罪犯，較早使用非法物質與違法的族群在各項物質使用的年齡皆顯著較低。本研究又發現少年罪犯逐年有明顯的較高機會罹患非法藥物使用疾患、明顯的較大機會使用搖頭丸、大麻和安非他命。

Objective:The objective of this study was to explore the relationship between earlier age of initiation of substance use, criminal behavior and parental risk factors and later delinquency and psychiatric comorbidity among male juvenile delinquents in Taiwan. Methods:We recruited a sample of 52 participants and divided them into three groups according to their history of criminal behavior and illicit substance use before the age of 15. All of the participants completed a twophase assessment including a self-administered questionnaire and a diagnostic interview with Chinese version of the Schedule for Affective Disorders and Schizophrenia for Children-Epidemiology Version (K-SADS-E). Results:The mean age of all kinds of substance use was significantly lowest in the group of earlier age of initiation of illicit drug use and criminal behavior (p< 0.05). Adjusting for age, all participants showed a greater chance significantly of having illicit drug use disorder (OR = 2.07, 95% CI = 1.19 -3.61, p< 0.01); MDMA use (OR = 1.62, 95% CI = 1.05-2.60, p< 0.05); marijuana use (OR = 1.69, 95% CI = 1.07-2.68, p< 0.05), and amphetamine use (OR = 1.57, 95% CI = 1.02-2.42, p< 0.05) for every oneyear older in age. Conclusion:The study findings showed that early-age male criminal had the tendency of using illicit drug use at lower age, and that those early male criminals tended to use MDMA, marijuana and amphetamine at their lower age.