McGee R, Williams S, Poulton R, Moffitt T
Department of Preventive & Social Medicine, University of Otago Medical School, Dunedin, New Zealand.
Addiction. 2000 Apr;95(4):491-503. doi: 10.1046/j.1360-0443.2000.9544912.x.
To examine the longitudinal association between cannabis use and mental health.
Information concerning cannabis use and mental health from 15 to 21 years was available for a large sample of individuals as part of a longitudinal study from childhood to adulthood.
Participants were enrolled in the Dunedin Multidisciplinary Health and Development Study, a research programme on the health, development and behaviour of a large group of New Zealanders born between 1 April 1972 and 31 March 1973.
Cannabis use and identification of mental disorder was based upon self-report as part of a general assessment of mental health using a standard diagnostic interview. Daily smoking and alcohol use at age 15 were assessed by self-report. Indices of family socio-economic status, family climate and parent-child interaction were formed using information gathered from parent report and behavioural observations over early childhood. Childhood behaviour problems were assessed by parent and teacher report. Attachment to parents was assessed in adolescence.
Cross-sectional associations between cannabis use and mental disorder were significant at all three ages. Both outcome variables shared similar pathways of low socio-economic status and history of behaviour problems in childhood, and low parental attachment in adolescence. Mental disorder at age 15 led to a small but significantly elevated risk of cannabis use at age 18; by contrast, cannabis use at age 18 elevated the risk of mental disorder at age 21. The latter association reflected the extent to which cannabis dependence and other externalizing disorders at age 21 were predicted by earlier level of involvement with cannabis.
The findings suggest that the primary causal direction leads from mental disorder to cannabis use among adolescents and the reverse in early adulthood. Both alcohol use and cigarette smoking had independent associations with later mental health disorder.
研究大麻使用与心理健康之间的纵向关联。
作为一项从童年到成年的纵向研究的一部分，大量个体提供了15至21岁期间大麻使用和心理健康的信息。
参与者被纳入达尼丁多学科健康与发展研究，这是一项关于1972年4月1日至1973年3月31日出生的一大群新西兰人的健康、发展和行为的研究项目。
大麻使用和精神障碍的识别基于自我报告，这是使用标准诊断访谈对心理健康进行总体评估的一部分。15岁时的每日吸烟和饮酒情况通过自我报告进行评估。家庭社会经济地位、家庭氛围和亲子互动指数是利用从父母报告和幼儿期行为观察中收集的信息形成的。童年行为问题通过父母和教师报告进行评估。青少年时期对父母的依恋情况进行了评估。
在所有三个年龄段，大麻使用与精神障碍之间的横断面关联均显著。两个结果变量都有相似的途径，即社会经济地位低、童年有行为问题史以及青少年时期父母依恋程度低。15岁时的精神障碍导致18岁时大麻使用风险略有但显著升高；相比之下，18岁时使用大麻会增加21岁时患精神障碍的风险。后一种关联反映了21岁时大麻依赖和其他外化障碍在多大程度上可由早期对大麻的使用程度预测。
研究结果表明，在青少年中，主要的因果方向是从精神障碍到大麻使用，而在成年早期则相反。饮酒和吸烟都与后期的精神健康障碍有独立关联。
