Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK; Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, AF, SE5 8, UK; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, CM1 1SQ, UK.
Eur Psychiatry. 2019 Feb;56:8-13. doi: 10.1016/j.eurpsy.2018.10.006. Epub 2018 Nov 15.
Evidence suggests that cannabis use may be associated with suicidality in adolescence. Nevertheless, very few studies have assessed this association in low- and middle-income countries (LMICs). In this cross-sectional survey, we investigated the association of cannabis use and suicidal attempts in adolescents from 21 LMICs, adjusting for potential confounders.
Data from the Global school-based Student Health Survey was analyzed in 86,254 adolescents from 21 countries [mean (SD) age = 13.7 (0.9) years; 49.0% girls]. Suicide attempts during past year and cannabis during past month and lifetime were assessed. Multivariable logistic regression analyses were conducted.
The overall prevalence of past 30-day cannabis use was 2.8% and the age-sex adjusted prevalence varied from 0.5% (Laos) to 37.6% (Samoa), while the overall prevalence of lifetime cannabis use was 3.9% (range 0.5%-44.9%). The overall prevalence of suicide attempts during the past year was 10.5%. Following multivariable adjustment to potential confounding variables, past 30-day cannabis use was significantly associated with suicide attempts (OR = 2.03; 95% CI: 1.42-2.91). Lifetime cannabis use was also independently associated with suicide attempts (OR = 2.30; 95% CI: 1.74-3.04).
Our data indicate that cannabis use is associated with a greater likelihood for suicide attempts in adolescents living in LMICs. The causality of this association should be confirmed/refuted in prospective studies to further inform public health policies for suicide prevention in LMICs.
有证据表明，大麻使用可能与青少年自杀意念有关。然而，很少有研究评估中低收入国家（LMICs）的这种关联。在这项横断面调查中，我们调查了 21 个 LMICs 中青少年大麻使用与自杀企图之间的关联，调整了潜在的混杂因素。
对来自 21 个国家的 86254 名青少年（平均年龄[标准差]为 13.7[0.9]岁；49.0%为女性）进行全球学校学生健康调查数据分析。评估过去一年的自杀企图和过去一个月及一生中的大麻使用情况。进行多变量逻辑回归分析。
过去 30 天大麻使用率为 2.8%，年龄性别调整后的使用率从 0.5%（老挝）到 37.6%（萨摩亚）不等，而终生大麻使用率为 3.9%（范围 0.5%-44.9%）。过去一年自杀企图的总发生率为 10.5%。在对潜在混杂变量进行多变量调整后，过去 30 天的大麻使用与自杀企图显著相关（OR=2.03；95%CI：1.42-2.91）。终生大麻使用也与自杀企图独立相关（OR=2.30；95%CI：1.74-3.04）。
我们的数据表明，大麻使用与生活在 LMICs 的青少年自杀企图的可能性增加有关。在未来的研究中，应该证实/反驳这种关联的因果关系，以进一步为 LMICs 的预防自杀的公共卫生政策提供信息。
