The relationship between cannabis use disorders and social anxiety disorder in the National Epidemiological Study of Alcohol and Related Conditions (NESARC)
The relationship between cannabis use disorders and social anxiety disorder in the National Epidemiological Study of Alcohol and Related Conditions (NESARC)
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DOI：
10.1016/j.drugalcdep.2011.12.023
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发表时间：
2012-07-01
影响因子：
4.2
通讯作者：
Blanco, Carlos
中科院分区：
文献类型：
--
作者：
Buckner, Julia D.;Heimberg, Richard G.;Blanco, Carlos
背景：大麻使用障碍（CUD）与社交焦虑障碍（SAD）高度共存，而 SAD 可能是大麻依赖的危险因素。这项研究通过多种方式探讨了这些关系。首先，我们研究了季节性情感障碍是否更可能与大麻依赖相关，而不是与滥用相关。其次，我们研究了 CUD 和 SAD 之间的时间关系。第三，我们研究了相对于其他焦虑症，SAD 是否与从首次使用大麻的年龄到 CUD 发作的更快转变有关。第四，我们测试了患有这两种疾病是否与更大的损害和精神共病相关。方法：样本由国家酒精和相关疾病流行病学调查第一波的成年人组成，其中 2957 人患有 CUD 但没有 SAD，1643 人患有 SAD 但没有 CUD，340 人患有 CUD-SAD。结果：SAD 更可能与大麻依赖相关，而不是滥用。在控制了种族、性别和一些其他精神疾病（包括一些焦虑症）后，这种关系仍然存在。发病年龄数据表明，对于大多数 CUD-SAD 受访者来说，SAD 发病早于 CUD 发病。与单独的任何一种疾病相比，CUD-SAD 与更大的损伤和精神合并症相关。结论：虽然 SAD 与 CUD 相关，但它与大麻依赖的相关性比滥用更强。本研究中测量的其他精神病理学并不能更好地解释这种联系。对于大多数 CUD-SAD 受访者来说，SAD 发生在 CUD 之前。重要的是，这两种疾病同时发生似乎比单独任何一种疾病造成更大的损害和痛苦。 (C) 2012 Elsevier Ireland Ltd. 保留所有权利。
Background: Cannabis use disorders (CUD) are highly comorbid with social anxiety disorder (SAD), and SAD may be a risk factor for cannabis dependence. This study explored these relationships in several ways. First, we examined whether SAD was more likely to be related to cannabis dependence than abuse. Second, we examined the temporal relations between CUD and SAD. Third, we examined whether SAD was related to faster transition from age of first cannabis use to CUD onset relative to other anxiety disorders. Fourth, we tested whether having both disorders was associated with greater impairment and psychiatric comorbidity.Method: The sample consisted of adults from Wave 1 of the National Epidemiological Survey on Alcohol and Related Conditions, 2957 of whom had CUD and no SAD, 1643 had SAD and no CUD, and 340 had CUD-SAD.Results: SAD was more likely to be related to cannabis dependence than abuse. This relation remained after controlling for race, sex, and some other psychiatric disorders (including some anxiety disorders). Age-of-onset data suggest SAD onset prior to CUD onset for most CUD-SAD respondents. CUD-SAD was related to greater impairment and psychiatric comorbidity than either disorder alone.Conclusions: Although SAD is related to CUD, it has a stronger association with cannabis dependence than abuse. This link is not better accounted for by other psychopathology measured in this study. SAD onset prior to CUD for the majority of CUD-SAD respondents. Importantly, the co-occurrence of these two disorders appears to result in greater impairment and distress than either disorder alone. (C) 2012 Elsevier Ireland Ltd. All rights reserved.