The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood
The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood
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DOI：
10.1111/j.1360-0443.2012.04015.x
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发表时间：
2013-01-01
期刊：
影响因子：
6
通讯作者：
Patton, George C.
中科院分区：
文献类型：
--
作者：
Degenhardt, Louisa;Coffey, Carolyn;Patton, George C.
关于青少年使用大麻与常见精神障碍之间的关联是否是因果关系的争论仍在继续。大多数报告都集中在青春期的关联，很少有研究延伸到成年期。我们在一个具有代表性的澳大利亚年轻人前瞻性队列中研究了从青春期到29岁的相关性。设计九波，15年的代表性纵向队列研究，其中六波数据收集在青春期（平均年龄14.9 - 17.4岁）和三个在年轻的成年人（平均年龄20.7，24.1和29.1岁）。参与者是在中学招募的1943人的队列，并在可能的情况下从青少年中期到20多岁的每一波进行调查。背景是澳大利亚维多利亚。在每个青少年阶段采用修订的临床访谈量表（CIS-R）评估精神病发病率，并在29岁时采用复合国际诊断访谈（CIDI）定义的ICD-10重度抑郁发作和焦虑障碍。在过去6个月中，对青少年使用大麻的频率进行了测量。去年大麻使用频率和DSM-IV大麻依赖性被评估为29岁。这些结果与大麻使用和依赖的横截面和前瞻性关联估计为优势比（OR），使用多变量logistic回归模型，在29岁时关注的结果，重度抑郁发作（MDE）和焦虑症（AD）。青少年大麻使用和29岁时的抑郁症之间没有一致的关联。每日使用大麻与29岁时的焦虑症相关[调整OR 2.5，95%置信区间（CI）：< 1.25.2]，大麻依赖也是如此（调整OR 2.2，95% CI：1.14.4）。在每周+青少年大麻使用者中，那些在29岁时继续每天使用大麻的人患焦虑症的几率仍然显著增加（调整后OR 3.2，95% CI：1.19.2）。定期（特别是每天）青少年大麻使用与焦虑，但不抑郁症，在青春期和成年后期，即使在经常使用者，然后停止使用药物。早期接触大麻可能会导致一般使用大麻的青少年人群出现持久的心理健康风险。
Aims Debate continues about whether the association between cannabis use in adolescence and common mental disorders is causal. Most reports have focused on associations in adolescence, with few studies extending into adulthood. We examine the association from adolescence until the age of 29 years in a representative prospective cohort of young Australians. Design Nine-wave, 15-year representative longitudinal cohort study, with six waves of data collection in adolescence (mean age 14.917.4 years) and three in young adulthood (mean age 20.7, 24.1 and 29.1 years). Participants Participants were a cohort of 1943 recruited in secondary school and surveyed at each wave when possible from mid-teen age to their late 20s. Setting Victoria, Australia. Measurements Psychiatric morbidity was assessed with the Revised Clinical Interview Schedule (CIS-R) at each adolescent wave, and as Composite International Diagnostic Interview (CIDI)-defined ICD-10 major depressive episode and anxiety disorder at 29 years. Frequency of cannabis use was measured in the past 6 months in adolescence. Cannabis use frequency in the last year and DSM-IV cannabis dependence were assessed at 29 years. Cross-sectional and prospective associations of these outcomes with cannabis use and dependence were estimated as odds ratios (OR), using multivariable logistic regression models, with the outcomes of interest, major depressive episode (MDE) and anxiety disorder (AD) at 29 years. Findings There were no consistent associations between adolescent cannabis use and depression at age 29 years. Daily cannabis use was associated with anxiety disorder at 29 years [adjusted OR 2.5, 95% confidence interval (CI):< 1.25.2], as was cannabis dependence (adjusted OR 2.2, 95% CI: 1.14.4). Among weekly+ adolescent cannabis users, those who continued to use cannabis use daily at 29 years remained at significantly increased odds of anxiety disorder (adjusted OR 3.2, 95% CI: 1.19.2). Conclusions Regular (particularly daily) adolescent cannabis use is associated consistently with anxiety, but not depressive disorder, in adolescence and late young adulthood, even among regular users who then cease using the drug. It is possible that early cannabis exposure causes enduring mental health risks in the general cannabis-using adolescent population.