Perkonigg A, Lieb R, Höfler M, Schuster P, Sonntag H, Wittchen H U
Max-Planck Institute of Psychiatry, Clinical Psychology and Epidemiology, Munich, Germany.
Addiction. 1999 Nov;94(11):1663-78. doi: 10.1046/j.1360-0443.1999.941116635.x.
To present data on the incidence of cannabis use at follow-up, and its progression, stability, abuse and dependence in a representative sample of adolescents (N = 1228), aged 14-17 years at "baseline"--the outset of the study--in Munich, Germany.
The study employed a prospective longitudinal design using a representative population sample. The mean follow-up time was 19.7 months. The Composite International Diagnostic Interview (M-CIDI) was used to assess patterns of use, abuse and dependence according to DSM-IV criteria.
(1) In our sample, 34.8% of males and 30.2% of females had tried cannabinoids at least once. (2) Of those who used cannabis repeatedly (two or four times) at baseline, 26.1% stopped using by follow-up; the majority went on to regular use in the follow-up period. Similarly, only 17.7% of the regular users at the outset stopped using cannabis completely; 74.2% continued their pattern of regular use. Thus, the higher the baseline use pattern, the higher was the probability of continued or heavier use during follow-up. (3) Although the cumulative life-time incidence for DSM-IV cannabis abuse (3.5%) in this age group was low, it is noteworthy that complete diagnostic remissions were relatively rare (31.7% for dependence, 41.1% for abuse). (4) There was considerable concurrent use of other drugs.
Cannabis use was almost as widespread in this sample of adolescents in Germany as in similar age groups in metropolitan areas of North America. There was a relatively low spontaneous remission rate among regular and repeated users. Cannabis use in adolescence appears to be less transient than many people would believe.
呈现德国慕尼黑一项针对14至17岁青少年（“基线”，即研究开始时N = 1228）代表性样本的随访中大麻使用的发生率及其进展、稳定性、滥用和依赖情况的数据。
本研究采用前瞻性纵向设计，使用具有代表性的人群样本。平均随访时间为19.7个月。采用综合国际诊断访谈（M - CIDI）根据《精神疾病诊断与统计手册》第四版标准评估使用、滥用和依赖模式。
（1）在我们的样本中，34.8%的男性和30.2%的女性至少尝试过一次大麻素。（2）在基线时反复使用大麻（两次或四次）的人群中，26.1%在随访时停止使用；大多数人在随访期间继续经常使用。同样，一开始经常使用大麻的人群中只有17.7%完全停止使用大麻；74.2%继续保持经常使用的模式。因此，基线使用模式越高，随访期间继续使用或增加使用量的可能性就越高。（3）尽管该年龄组中《精神疾病诊断与统计手册》第四版定义的大麻滥用的累积终生发生率较低（3. Five percent），但值得注意的是，完全诊断缓解相对较少（依赖为31.7%，滥用为41.1%）。（4）存在大量其他药物的同时使用情况。
在德国的这个青少年样本中，大麻使用几乎与北美大都市地区类似年龄组一样普遍。经常和反复使用者的自发缓解率相对较低。青少年时期的大麻使用似乎不像许多人认为的那样短暂。
