Department of Psychology, Ohio University, Athens, Ohio.
VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, New York.
Depress Anxiety. 2019 Nov;36(11):1072-1079. doi: 10.1002/da.22954. Epub 2019 Sep 2.
The current study examines the unique and interactive effects of posttraumatic stress disorder (PTSD) symptoms and days using alcohol, opioids, and marijuana on PTSD symptoms, suicidal ideation, and suicidal behavior up to 1 year, later in a high-risk sample of military personnel not active in mental health treatment.
Current and former military personnel at risk for suicide (N = 545; M age = 31.91 years, standard deviation = 7.27; 88.2% male) completed self-report measures of PTSD symptoms, past 30 days heavy alcohol use, opioid use, marijuana use, and current suicidal ideation via telephone at baseline and 1, 3, 6, and 12 months later. PTSD symptoms and the substance use variables (and relevant covariates) were entered as predictors of changes in PTSD symptoms, the likelihood of suicidal ideation, suicidal ideation severity, and the likelihood of suicidal behavior during the 11-month follow-up period.
PTSD symptoms predicted PTSD symptoms 1 month later. PTSD symptoms and marijuana use predicted the likelihood of suicidal ideation 1 month later and suicidal behavior during the 11-month follow-up period. The interaction between PTSD symptoms and marijuana use significantly predicted increased PTSD symptoms over time and suicidal behavior. At high, but not low levels of PTSD symptoms, more days using marijuana predicted increased PTSD symptoms over time and the likelihood of suicidal behavior.
Results suggest marijuana, especially for military personnel experiencing elevated PTSD symptoms may negatively impact suicidal thoughts and behavior. These results are relevant to suggestions that medical marijuana could be used in treating or augmenting treatment for PTSD.
本研究考察了创伤后应激障碍（PTSD）症状和使用酒精、阿片类药物和大麻的天数对 PTSD 症状、自杀意念和自杀行为的独特和交互影响，随访时间长达 1 年，研究对象为未积极接受心理健康治疗的高危军事人员。
有自杀风险的现役和退役军人（N=545；M 年龄=31.91 岁，标准差=7.27；88.2%为男性）通过电话在基线及 1、3、6 和 12 个月后完成 PTSD 症状、过去 30 天重度饮酒、阿片类药物使用、大麻使用和当前自杀意念的自评量表。PTSD 症状和物质使用变量（及相关协变量）被纳入预测因子，以预测 PTSD 症状变化、自杀意念、自杀意念严重程度和 11 个月随访期间自杀行为的可能性。
PTSD 症状预测 1 个月后 PTSD 症状。PTSD 症状和大麻使用预测 1 个月后自杀意念的可能性和 11 个月随访期间自杀行为的可能性。PTSD 症状和大麻使用的交互作用显著预测了随时间推移 PTSD 症状的增加和自杀行为。在 PTSD 症状高（而非低）水平时，更多的大麻使用天数预示着随时间推移 PTSD 症状的增加和自杀行为的可能性。
结果表明，大麻可能会对自杀念头和行为产生负面影响，尤其是对 PTSD 症状较高的军人。这些结果与使用医用大麻治疗或增强 PTSD 治疗的建议有关。
