Bidirectional relationships between cannabis use, anxiety and depressive symptoms in the mediation of the association with psychotic experience: further support for an affective pathway to psychosis.
Bidirectional relationships between cannabis use, anxiety and depressive symptoms in the mediation of the association with psychotic experience: further support for an affective pathway to psychosis.
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DOI：
10.1017/s0033291722002756
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发表时间：
2023-09
影响因子：
6.9
通讯作者：
Guloksuz, Sinan
中科院分区：
文献类型：
--
作者：
Radhakrishnan, Rajiv;Pries, Lotta-Katrin;Erzin, Gamze;ten Have, Margreet;de Graaf, Ron;van Dorsselaer, Saskia;Gunther, Nicole;Bak, Maarten;Rutten, Bart P. F.;van Os, Jim;Guloksuz, Sinan
关键词：
经验证据表明，人们使用大麻可以缓解焦虑和抑郁症状，但大麻也会严重恶化精神病和情感症状。然而，在纵向研究中，大麻使用、焦虑和抑郁症状以及精神病经历（PE）之间的时间关系尚不清楚。这可以通过检查大麻、焦虑和抑郁症状在PE出现中的相互调解作用来了解。数据来源于第二次荷兰纵向心理健康调查和发病率研究。使用STATA中的KHB logit进行中介分析，以检查大麻使用、焦虑/抑郁症状和PE之间的关系，同时调整年龄、性别和教育状况。研究发现，大麻使用介导了之前的焦虑、抑郁症状和后来的PE发病率之间的关系，但大麻使用的间接贡献很小（对于焦虑：大麻使用占总效应的百分比= 1.00%；对于抑郁：大麻使用占总效应的百分比= 1.4%）。有趣的是，焦虑和抑郁症状被发现在更大程度上介导了先前使用大麻与后来PE发病率之间的关系（焦虑占总效应的百分比= 17%；抑郁占总效应的百分比= 37%）。这项首次纵向队列研究考察了大麻使用、焦虑/抑郁症状和PE之间的中介关系，表明大麻使用、焦虑/抑郁症状和PE之间存在双向关系。然而，焦虑/抑郁症状作为中介的贡献大于大麻。
Empirical evidence suggests that people use cannabis to ameliorate anxiety and depressive symptoms, yet cannabis also acutely worsens psychosis and affective symptoms. However, the temporal relationship between cannabis use, anxiety and depressive symptoms and psychotic experiences (PE) in longitudinal studies is unclear. This may be informed by examination of mutually mediating roles of cannabis, anxiety and depressive symptoms in the emergence of PE. Data were derived from the second longitudinal Netherlands Mental Health Survey and Incidence Study. Mediation analysis was performed to examine the relationship between cannabis use, anxiety/depressive symptoms and PE, using KHB logit in STATA while adjusting for age, sex and education status. Cannabis use was found to mediate the relationship between preceding anxiety, depressive symptoms and later PE incidence, but the indirect contribution of cannabis use was small (for anxiety: % of total effect attributable to cannabis use = 1.00%; for depression: % of total effect attributable to cannabis use = 1.4%). Interestingly, anxiety and depressive symptoms were found to mediate the relationship between preceding cannabis use and later PE incidence to a greater degree (% of total effect attributable to anxiety = 17%; % of total effect attributable to depression = 37%). This first longitudinal cohort study examining the mediational relationship between cannabis use, anxiety/depressive symptoms and PE, shows that there is a bidirectional relationship between cannabis use, anxiety/depressive symptoms and PE. However, the contribution of anxiety/depressive symptoms as a mediator was greater than that of cannabis.