Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA.
Drug Alcohol Depend. 2012 Jul 1;124(1-2):128-34. doi: 10.1016/j.drugalcdep.2011.12.023. Epub 2012 Jan 21.
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.
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.
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.
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.
大麻使用障碍（CUD）与社交焦虑障碍（SAD）高度共病，而 SAD 可能是大麻依赖的一个风险因素。本研究从多个方面探讨了这些关系。首先，我们检查了 SAD 是否更有可能与大麻依赖有关，而不是滥用。其次，我们检查了 CUD 和 SAD 之间的时间关系。第三，我们检查了 SAD 是否与从首次使用大麻到 CUD 发病的年龄更快过渡有关，而不是其他焦虑障碍。第四，我们测试了同时患有这两种疾病是否与更大的损伤和精神共病有关。
该样本由来自国家酒精和相关条件流行病学调查第 1 波的成年人组成，其中 2957 人患有 CUD 但无 SAD，1643 人患有 SAD 但无 CUD，340 人患有 CUD-SAD。
SAD 与大麻依赖的关系比滥用更密切。在控制种族、性别和一些其他精神障碍（包括一些焦虑障碍）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 的发病先于 CUD。与单独患有 CUD 或 SAD 相比，CUD-SAD 与更大的损伤和精神共病有关。
尽管 SAD 与 CUD 有关，但它与大麻依赖的关系比滥用更密切。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 的发病先于 CUD。重要的是，这两种疾病的同时发生似乎比单独患有这两种疾病导致更大的损伤和痛苦。
