National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Addiction. 2013 Jan;108(1):124-33. doi: 10.1111/j.1360-0443.2012.04015.x. Epub 2012 Oct 18.
Debate continues about whether the association between cannabis use in adolescence and common mental disorders is causal. Most reports have focused on associations in adolescence, with few studies extending into adulthood. We examine the association from adolescence until the age of 29 years in a representative prospective cohort of young Australians.
Nine-wave, 15-year representative longitudinal cohort study, with six waves of data collection in adolescence (mean age 14.9-17.4 years) and three in young adulthood (mean age 20.7, 24.1 and 29.1 years).
Participants were a cohort of 1943 recruited in secondary school and surveyed at each wave when possible from mid-teen age to their late 20s.
Victoria, Australia.
Psychiatric morbidity was assessed with the Revised Clinical Interview Schedule (CIS-R) at each adolescent wave, and as Composite International Diagnostic Interview (CIDI)-defined ICD-10 major depressive episode and anxiety disorder at 29 years. Frequency of cannabis use was measured in the past 6 months in adolescence. Cannabis use frequency in the last year and DSM-IV cannabis dependence were assessed at 29 years. Cross-sectional and prospective associations of these outcomes with cannabis use and dependence were estimated as odds ratios (OR), using multivariable logistic regression models, with the outcomes of interest, major depressive episode (MDE) and anxiety disorder (AD) at 29 years.
There were no consistent associations between adolescent cannabis use and depression at age 29 years. Daily cannabis use was associated with anxiety disorder at 29 years [adjusted OR 2.5, 95% confidence interval (CI):< 1.2-5.2], as was cannabis dependence (adjusted OR 2.2, 95% CI: 1.1-4.4). Among weekly+ adolescent cannabis users, those who continued to use cannabis use daily at 29 years remained at significantly increased odds of anxiety disorder (adjusted OR 3.2, 95% CI: 1.1-9.2).
Regular (particularly daily) adolescent cannabis use is associated consistently with anxiety, but not depressive disorder, in adolescence and late young adulthood, even among regular users who then cease using the drug. It is possible that early cannabis exposure causes enduring mental health risks in the general cannabis-using adolescent population.
关于青少年时期大麻使用与常见精神障碍之间的关联是否具有因果关系，一直存在争议。大多数报告都集中在青少年时期的关联上，很少有研究扩展到成年期。我们在澳大利亚年轻人群体的代表性前瞻性队列中，从青少年时期一直研究到 29 岁。
9 波、15 年的代表性纵向队列研究，青少年时期有 6 次数据采集（平均年龄 14.9-17.4 岁），成年早期有 3 次（平均年龄 20.7、24.1 和 29.1 岁）。
参与者为 1943 名在中学招募的队列，在青少年时期的每一个波次中进行调查，尽可能在青少年中期到 20 多岁后期进行调查。
澳大利亚维多利亚州。
使用修订后的临床访谈时间表（CIS-R）在每个青少年波次评估精神疾病发病率，在 29 岁时使用复合国际诊断访谈（CIDI）定义的 ICD-10 重性抑郁发作和焦虑障碍进行评估。在青少年时期的过去 6 个月内测量大麻使用频率。在 29 岁时评估过去一年的大麻使用频率和 DSM-IV 大麻依赖。使用多变量逻辑回归模型，以 29 岁时的重性抑郁发作（MDE）和焦虑障碍（AD）为感兴趣的结局，估计这些结局与大麻使用和依赖的横断面和前瞻性关联，使用比值比（OR）。
青少年时期的大麻使用与 29 岁时的抑郁之间没有一致的关联。每日大麻使用与 29 岁时的焦虑障碍相关[调整后的 OR 2.5，95%置信区间（CI）：<1.2-5.2]，大麻依赖（调整后的 OR 2.2，95% CI：1.1-4.4）也与焦虑障碍相关。在每周+青少年大麻使用者中，那些在 29 岁时仍继续每天使用大麻的人，患焦虑障碍的几率仍然显著增加[调整后的 OR 3.2，95% CI：1.1-9.2]。
青少年时期经常（特别是每日）使用大麻与焦虑有关，但与抑郁无关，即使是在那些随后停止使用大麻的经常使用者中也是如此。在一般的大麻使用者青少年群体中，早期接触大麻可能会导致持久的精神健康风险。
