Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study
Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study
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DOI：
10.1136/bmj.325.7374.1199
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发表时间：
2002-11-23
影响因子：
--
通讯作者：
Lewis, G
中科院分区：
文献类型：
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作者：
Zammit, S;Allebeck, P;Lewis, G
目的在瑞典应征入伍者的随访中，先前报道了青春期使用大麻与随后患精神分裂症风险之间的关联。有人提出，这种关联可能是由于使用大麻以外的药物，人格特征可能会混淆结果。我们对这一队列进行了进一步的分析，以解决这些不确定性，同时延长随访期，以确定额外的病例。设计历史队列研究。（超过全国18 - 20岁男性人口的97%）。数据来自自我报告的大麻和其他药物的使用，以及一些社会和心理特征。主要结果测量因ICD-8/9精神分裂症和其他精神病住院的人数，结果大麻与精神分裂症发病风险增加相关，且呈剂量依赖性，（频率增加的线性趋势的校正比值比为1.2，95%置信区间为1.1至1.4，P <0.001），仅使用大麻而未使用其他药物的受试者中（线性趋势的校正比值比为1.3，1.1至1.5，P <0.015）。在仅使用大麻组中，使用大麻> 50次的调整后比值比为6.7（2.1至21.7）。当分析仅限于受试者发展精神分裂症后五年征兵，排除前驱cases.Conclusions大麻的使用与发展精神分裂症的风险增加，符合因果关系时，得到了类似的结果。这种关联不能用其他精神药物的使用或与社会融合有关的人格特征来解释。
Objectives An association between use of cannabis in adolescence and subsequent risk of schizophrenia was previously reported in a follow up of Swedish conscripts. Arguments were raised that this association may be due to use of drugs other than cannabis and that personality traits may have confounded results. We performed a further analysis of this cohort to address these uncertainties while extending the follow up period to identify additional cases.Design Historical cohort study.Setting 1969-70 survey of Swedish conscripts (> 97% of the country's male population aged 18-20).Participants 50 087 subjects: data were available on self reported use of cannabis and other drugs, and on several social and psychological characteristics.Main outcome measures Admissions to hospital for ICD-8/9 schizophrenia and other psychoses, as determined by record linkage.Results Cannabis was associated with an increased risk of developing schizophrenia in a dose dependent fashion both for subjects who had ever used cannabis (adjusted odds ratio for linear trend of increasing frequency 1.2, 95% confidence interval 1.1 to 1.4, P < 0.001), mid for subjects who had used only cannabis and no other drugs (adjusted odds ratio for linear trend 1.3, 1.1 to 1.5, P < 0.015). The adjusted odds ratio for using cannabis > 50 times was 6.7 (2.1 to 21.7) in the cannabis only group. Similar results were obtained when analysis was restricted to subjects developing schizophrenia after five years after conscription, to exclude prodromal cases.Conclusions Cannabis use is associated with an increased risk of developing schizophrenia, consistent with a causal relation. This association is not explained by use of other psychoactive drugs or personality traits relating to social integration.