What predicts incident use of cannabis and progression to abuse and dependence?: A 4-year prospective examination of risk factors in a community sample of adolescents and young adults
What predicts incident use of cannabis and progression to abuse and dependence?: A 4-year prospective examination of risk factors in a community sample of adolescents and young adults
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DOI：
10.1016/s0376-8716(02)00102-3
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发表时间：
2002-09-01
影响因子：
4.2
通讯作者：
Wittchen, HU
中科院分区：
文献类型：
--
作者：
von Sydow, K;Lieb, R;Wittchen, HU
目的：确定青少年和青年社区样本中大麻使用、滥用和依赖事件发生的风险因素。研究方法：在为期4年的前瞻性纵向设计中，在研究开始时（EDSP），在14-24岁的代表性样本（N = 2446）中检查了风险因素，使用复合国际诊断访谈（M-CIDI）评估了DSM-IV定义的大麻使用，滥用和依赖模式。在基线时评估潜在风险因素。第二次随访时（基线后平均42个月）的大麻使用、滥用和依赖事件是本研究的主要结局指标。相关性进行了分析与逻辑和负二项回归，结果：使用I/I的共56个变量检查，最终的多元逻辑回归事件大麻使用的预测值是中等良好的（ROC曲线下面积= 0.78）。在最终模型中，大麻使用频率由18个变量预测，大麻滥用由年轻子样本中的两个变量和老年组中的九个因素预测，依赖性由八个变量预测（依赖性：ROC曲线面积= 0.97）。事件大麻使用预测主要是通过药物的可用性，同龄人的药物使用，对未来药物使用的更“积极”的态度，以及以前经常使用合法药物，而大麻依赖主要是通过父母在15岁之前死亡，被剥夺的社会经济地位和基线使用其他非法药物来预测的。结论：不同的因素预测大麻使用的发作或严重程度以及滥用和依赖的进展。除了有据可查的风险因素外，例如同龄群体压力、药物供应。研究结果表明，家族史（如父母精神障碍、父母早逝）和以前使用法律的药物的经历在青少年和年轻人开始吸食大麻和过渡到大麻使用障碍方面起着重要作用。研究结果表明，早期干预和预防可能会通过更好的针对性治疗得到改善。(C)2002爱思唯尔科学爱尔兰有限公司保留所有权利。
Objectives: To determine risk factors of incident onset of use, abuse and dependence of cannabis in a community sample of adolescents and young adults. Methods: Risk factors were examined in a prospective longitudinal design across 4 years in a representative sample (N = 2446) aged 14-24 at the outset of the study (EDSP), Patterns of DSM-IV defined cannabis use, abuse and dependence were assessed with the Composite International Diagnostic Interview (M-CIDI). Potential risk factors were assessed at baseline. Incident cannabis use, abuse and dependence at second follow-up (on average 42 months after baseline) were the main outcome measures in this study. Associations were analyzed with logistic and negative binomial regressions, Results: Using I I of a total of 56 variables examined, the predictive value of the final multiple logistic regression for incident cannabis use was moderately good (area under the ROC curve = 0.78). Cannabis use frequency was predicted in the final model by 18 variables, cannabis abuse by two variables in the younger subsample and nine factors in the older group, and dependence by eight variables (dependence: ROC curve area = 0.97). Incident cannabis use was predicted mainly by availability of drugs, peers' drug use, a more 'positive' attitude towards future drug use, and regular previous use of licit drugs, while cannabis dependence was predicted primarily by parental death before age 15, deprived socio-economic status, and baseline use of other illicit drugs. Conclusion: Different factors predict the onset or severity of cannabis use and the progression to abuse and dependence. In addition to well-documented risk factors such as peer group pressure, drug availability. and low self-esteem, findings suggest that family history (e.g. parental mental disorders, early parental death), and prior experiences with legal drugs play a significant role in the initiation of cannabis consumption and the transition to cannabis use disorders in adolescents and young adults. Findings suggest that early intervention and prevention might be improved by better targeted treatment. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.