Department of Family Medicine, McMaster University, Hamilton, Canada.
Department of Psychiatry and Behavioral Neurosciences, McMaster University, 100 West 5th Street, Mood Disorders Program, Hamilton, Ontario, L8N 3K7, Canada.
Biol Sex Differ. 2018 Jun 11;9(1):22. doi: 10.1186/s13293-018-0182-x.
Cannabis is the most commonly used illicit drug. In the general population, its use has been linked to a heightened propensity for suicidal behavior (SB). We hypothesize that this association varies in patients with psychiatric disorders. SB is known to vary by sex and therefore an investigation of cannabis' association with SB must consider sex differences. The purpose of this study is to investigate the association between cannabis use and suicide attempts in men and women with psychiatric disorders.
We merged data collected for two studies based in Ontario, Canada (n = 985). We employed a multivariable logistic regression to assess the association between cannabis use and suicide attempts in men and women with psychiatric disorders.
We analyzed data from 465 men and 444 women. Amongst these, 112 men and 158 women had attempted suicide. The average age of our participants was 40 years (standard deviation (SD) 12.4). We found no significant association between suicide attempts and cannabis use in men (odds ratio (OR) = 1.34, 95% confidence interval (CI) 0.81, 2.22, p = 0.260) or women (OR = 0.97, 95% CI 0.61, 1.54, p = 0.884). In a sensitivity analysis using a sample of patients with substance use disorder only, the heaviness of cannabis use was associated with small but significant association with SB in men (OR = 1.03, 95% CI 1.01, 1.05, p = 0.007).
Our findings indicate that there is no association between cannabis use and suicidal behavior in men or women with psychiatric disorders unlike what was reported for the general population, though the heaviness of cannabis use may have an effect in men. The impact of cannabis use in psychiatric disorders needs ongoing examination in light of its common use, impending legalization with expected increased access and the uncertainty about cannabis' effects on prognosis of psychiatric disorders. In addition, research should continue to investigate modifiable risk factors of SB in this population of which cannabis is not a significant factor based on this study.
大麻是最常被滥用的非法药物。在普通人群中，大麻的使用与自杀行为（SB）的发生率升高有关。我们假设这种关联在患有精神疾病的患者中有所不同。SB 的发生因性别而异，因此研究大麻与 SB 的关联必须考虑性别差异。本研究旨在调查精神障碍患者中大麻使用与自杀企图之间的关系。
我们合并了加拿大安大略省两项研究的数据（n=985）。我们采用多变量逻辑回归来评估精神障碍患者中大麻使用与自杀企图之间的关系。
我们分析了 465 名男性和 444 名女性的数据。其中，112 名男性和 158 名女性有过自杀企图。参与者的平均年龄为 40 岁（标准差 12.4）。我们没有发现男性（比值比（OR）=1.34，95%置信区间（CI）0.81，2.22，p=0.260）或女性（OR=0.97，95%CI 0.61，1.54，p=0.884）自杀企图与大麻使用之间存在显著关联。在仅使用有物质使用障碍患者样本的敏感性分析中，大麻使用的严重程度与男性 SB 之间存在小但显著的关联（OR=1.03，95%CI 1.01，1.05，p=0.007）。
我们的研究结果表明，与普通人群的报告相反，在患有精神疾病的男性或女性中，大麻使用与自杀行为之间没有关联，尽管大麻使用的严重程度可能对男性有影响。鉴于大麻在普通人群中的广泛使用、即将合法化预计会增加获取途径以及对大麻对精神疾病预后影响的不确定性，有必要持续检查大麻在精神疾病中的使用情况。此外，基于这项研究，研究应继续调查该人群中 SB 的可改变风险因素，其中大麻不是一个重要因素。
