Lev Hasharon Medical Center, P.O. Box 90000, Netanya, 42100, Israel.
New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA.
Drug Alcohol Depend. 2019 Feb 1;195:170-177. doi: 10.1016/j.drugalcdep.2018.09.005. Epub 2018 Oct 22.
Cannabis withdrawal syndrome (CWS) was newly added to the Diagnostic and Statistical Manual of Mental Disorders in its most recent edition, DSM-5. With cannabis use increasing among U.S. adults, information is needed about the prevalence and correlates of DSM-5 CWS in the general population. This study presents nationally representative findings on the prevalence, sociodemographic and clinical correlates of DSM-5 CWS among U.S. adults.
Participants ≥18 years were interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) in 2012-2013. Among the sub-sample of frequent cannabis users in the prior 12 months (≥3 times a week; N = 1527), the prevalence and demographic and clinical correlates of DSM-5 CWS were examined.
In frequent cannabis users, the prevalence of CWS was 12.1%. The most common withdrawal symptoms among those with CWS were nervousness/anxiety (76.3%), hostility (71.9%), sleep difficulty (68.2%) and depressed mood (58.9%). CWS was associated with significant disability (p < 0.001), and with mood disorders (adjusted odds ratios [aOR] = 1.9-2.6), anxiety disorders (aOR = 2.4-2.5), personality disorders (aOR = 1.7-2.2) and family history of depression (aOR = 2.5) but not personal history of other substance use disorders or family history of substance use problems.
CWS is highly comorbid and disabling. Its shared symptoms with depressive and anxiety disorders call for clinician awareness of CWS and the factors associated with it to promote more effective treatment among frequent cannabis users.
大麻戒断综合征（CWS）在最新版的《精神疾病诊断与统计手册》（DSM-5）中被新纳入。随着美国成年人中大麻使用量的增加，需要了解普通人群中 DSM-5 CWS 的流行率和相关因素。本研究提供了美国成年人中 DSM-5 CWS 的流行率、社会人口学和临床相关因素的全国代表性发现。
在 2012-2013 年进行的全国酒精相关状况流行病学调查-III（NESARC-III）中，对年龄在 18 岁及以上的参与者进行了访谈。在过去 12 个月内（每周≥3 次）频繁使用大麻的亚样本中（N=1527），检查了 DSM-5 CWS 的流行率以及人口统计学和临床相关因素。
在频繁使用大麻的人群中，CWS 的患病率为 12.1%。患有 CWS 的人最常见的戒断症状是紧张/焦虑（76.3%）、敌意（71.9%）、睡眠困难（68.2%）和情绪低落（58.9%）。CWS 与显著的残疾相关（p<0.001），与心境障碍（调整后的优势比[aOR] = 1.9-2.6）、焦虑障碍（aOR = 2.4-2.5）、人格障碍（aOR = 1.7-2.2）和抑郁症家族史（aOR = 2.5）相关，但与其他物质使用障碍的个人史或物质使用问题的家族史无关。
CWS 高度共病且致残。它与抑郁和焦虑障碍的共同症状呼吁临床医生意识到 CWS 及其相关因素，以促进频繁使用大麻者更有效的治疗。
