Hasin Deborah S, Kerridge Bradley T, Saha Tulshi D, Huang Boji, Pickering Roger, Smith Sharon M, Jung Jeesun, Zhang Haitao, Grant Bridget F
From the Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Rockville, Md.; the Department of Epidemiology, Mailman School of Public Health, and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York; and the New York State Psychiatric Institute, New York.
Am J Psychiatry. 2016 Jun 1;173(6):588-99. doi: 10.1176/appi.ajp.2015.15070907. Epub 2016 Mar 4.
Attitudes toward marijuana are changing, the prevalence of DSM-IV cannabis use disorder has increased, and DSM-5 modified the cannabis use disorder criteria. Therefore, updated information is needed on the prevalence, demographic characteristics, psychiatric comorbidity, disability, and treatment for DSM-5 cannabis use disorder.
In 2012-2013, 36,309 participants ≥18 years old were interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III. Psychiatric and substance use disorders were assessed with the Alcohol Use Disorders and Associated Disabilities Interview Schedule-5.
The prevalences of 12-month and lifetime cannabis use disorder were 2.5% and 6.3%. Among those with 12-month and lifetime diagnoses, the mean days of marijuana use per year were 225.3 (SE=5.7) and 274.2 (SE=3.8). The odds of 12-month and lifetime cannabis use disorder were higher for men, Native Americans, unmarried individuals, those with low incomes, and young adults (e.g., among those age 18-24 years versus ≥45: odds ratio for 12-month disorder, 7.2; 95% confidence interval, 5.5-9.5). Cannabis use disorder was associated with other substance use disorders, affective disorders, anxiety, and personality disorders. Twelve-month cannabis use disorder was associated with disability. As disorder severity increased, virtually all associations became stronger. Only 13.2% with lifetime cannabis use disorder participated in 12-step programs or professional treatment.
DSM-5 cannabis use disorder is prevalent, associated with comorbidity and disability, and largely untreated. Findings suggest the need to improve prevention and educate the public, professionals, and policy makers about possible harms associated with cannabis use disorders and available interventions.
对大麻的态度正在改变,《精神疾病诊断与统计手册》第四版(DSM-IV)中大麻使用障碍的患病率有所上升,且《精神疾病诊断与统计手册》第五版(DSM-5)修改了大麻使用障碍的标准。因此,需要有关DSM-5大麻使用障碍的患病率、人口统计学特征、精神共病、残疾情况及治疗的最新信息。
在2012 - 2013年,对全国酒精及相关疾病流行病学调查三期(National Epidemiologic Survey on Alcohol and Related Conditions-III)中36309名18岁及以上的参与者进行了访谈。使用酒精使用障碍及相关残疾访谈表第五版(Alcohol Use Disorders and Associated Disabilities Interview Schedule-5)评估精神疾病和物质使用障碍。
12个月内和终生大麻使用障碍的患病率分别为2.5%和6.3%。在那些有12个月内及终生诊断的人群中,每年使用大麻的平均天数分别为225.3(标准误=5.7)和274.2(标准误=3.8)。男性、美国原住民、未婚者、低收入者及年轻人出现12个月内和终生大麻使用障碍的几率更高(例如,在18 - 24岁人群与45岁及以上人群中,12个月内障碍的优势比为7.2;95%置信区间为5.5 - 9.5)。大麻使用障碍与其他物质使用障碍、情感障碍、焦虑症及人格障碍有关。12个月内大麻使用障碍与残疾有关。随着障碍严重程度增加,几乎所有关联都变得更强。终生大麻使用障碍患者中只有13.2%参加了12步康复计划或接受专业治疗。
DSM-5大麻使用障碍很普遍,与共病和残疾有关,且大多未得到治疗。研究结果表明需要加强预防,并向公众、专业人员及政策制定者宣传与大麻使用障碍相关的潜在危害及可用干预措施。