Cannabis Use and Disorder From Childhood to Adulthood in a Longitudinal Community Sample With American Indians
Cannabis Use and Disorder From Childhood to Adulthood in a Longitudinal Community Sample With American Indians
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DOI：
10.1016/j.jaac.2016.11.006
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发表时间：
2017-02-01
影响因子：
13.3
通讯作者：
Shanahan, Lilly
中科院分区：
文献类型：
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作者：
Copeland, William E.;Hill, Sherika;Shanahan, Lilly
目的：DSM标准的最新变化要求对大麻使用障碍（CUD）的患病率和发展序列进行新的记录。本研究的目的是在一个具有社区代表性的美国印第安人样本中调查DSM-5的早期病程及其与dsm - 4和消费结构的重叠。方法：数据来自北卡罗来纳州的前瞻性、纵向、基于人群的大烟山研究（N = 1,420，包括349名美洲印第安人）。在9岁至16岁以及19岁、21岁、26岁和30岁的年度访谈中评估大麻使用和紊乱（从1993年到2015年，每个参与者多达11次评估）。到30岁时，大约70%的参与者使用过大麻，34%每天使用大麻，18%符合DSM-5 CUD的标准。大约四分之一的大麻使用者在某种程度上符合CUD的标准。与其他使用者相比，符合标准的人开始使用的时间超过2年（13.3岁）。尽管贫困加剧的风险更高，但美国印第安人的使用模式与其他样本相似。DSM-5 CUD与DSM-IV滥用或依赖之间的一致性是实质性的，但DSM-5 CUD与日常使用之间的一致性更高。结论：到成年时，每天使用大麻或符合DSM-5 CUD标准是很常见的。通过提高诊断阈值，DSM-5 CUD是对DSM-IV诊断结构的改进。
Objective: Recent changes in DSM criteria require new documentation of the prevalence and developmental sequences of cannabis use disorder (CUD). The goal of this study was to investigate the early course of DSM-5 CUD and its overlap with DSM-IV and consumption constructs in a community-representative sample of American Indians.Method: Data came from the prospective, longitudinal, population-based Great Smoky Mountains Study in North Carolina (N = 1,420, including 349 American Indians). Cannabis use and disorder were assessed during yearly interviews from 9 to 16 years of age and at 19, 21, 26, and 30 years of age (up to 11 assessments per participant from 1993 through 2015).Results; By 30 years of age, approximately 70% of participants had used cannabis, 34% had used cannabis daily, and 18% had met criteria for DSM-5 CUD. Approximately 1 in 4 cannabis users met criteria for CUD at some point. Those who met criteria initiated use more than 2 years previously (at 13.3 years old) compared with other users. Despite higher risks from increased poverty, American Indians' patterns of use were similar to those of the rest of the sample. Concordance between DSM-5 CUD and DSM-IV abuse or dependence was substantial but was even higher between DSM-5 CUD and daily use.Conclusion: It was common to have used cannabis daily or to have met criteria for DSM-5 CUD by adulthood. DSM-5 CUD was an improvement over DSM-IV diagnostic constructs by raising the threshold for diagnosis.