Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ, 27 Boulevard Jean Moulin, 13005, Marseille, France.
Eur Arch Psychiatry Clin Neurosci. 2021 Aug;271(5):857-864. doi: 10.1007/s00406-020-01131-0. Epub 2020 May 5.
France has been identified with one of the highest rates of cannabis consumption of Western European countries. Yet we lack data in medical students who are at risk of addictive behavior. The objective of the study is to determine the prevalence of cannabis consumption and cannabis use disorder (CUD) among French medical students and their association with psychotropic drug consumption and psychosocial factors. Medical students were recruited from 35 French universities of medicine through administration mailing lists and social networks, between December 2016 and May 2017. Cannabis consumption was self-declared by anonymous questionnaire and CUD was defined by a Cannabis Abuse Screening Test (CAST) score ≥ 3. 10,985 medical students with a mean age of 21.8 years (± 3.3) were included, 32% of which were men. Overall, 1642 [14.9 (14.3; 15.6)%] reported cannabis consumption and 622 [5.7 (5.2; 6.1)%] students were identified with CUD at screening. Men were at two-time higher risk of cannabis consumption and three-time higher risk of CUD (22.4% and 10.6% for men vs. 11.5% and 3.4%, respectively, for women). In multivariate analyses, men sex, alcohol use disorder, tobacco smoking, parents' divorce, and history of physical assault and lower rates of lower rates of ≥ 40 weekly worked hours were identified as common associated factors for cannabis consumption and CUD. Hypnotic consumption, psychiatric follow-up, and history of sexual assault were identified as factors associated specifically with CUD, suggesting that these factors were associated with more severe cannabis consumption. Only 17% of students identified with CUD reported a psychiatric follow-up. Altogether, these results suggest that health policies should target cannabis consumption in medical students that is frequent, especially in men, with low rates of psychiatric follow-up. We have identified psychological factors and increased hypnotic drug consumption in CUD participants suggesting that psychiatric follow-up should be systematically proposed to this group.
法国被认为是西欧国家中大麻消费水平最高的国家之一。然而，我们缺乏有关医学生成瘾行为风险的数据。本研究的目的是确定法国医学生中大麻消费和大麻使用障碍（CUD）的流行率，以及它们与精神药物消费和心理社会因素的关系。通过向 35 所法国医学院校的行政邮寄名单和社交网络发送问卷，于 2016 年 12 月至 2017 年 5 月期间招募了医学生。大麻消费情况通过匿名问卷自行报告，大麻滥用筛查测试（CAST）得分≥3 定义为 CUD。共纳入 10985 名医学生，平均年龄 21.8 岁（±3.3），其中 32%为男性。总体而言，1642 名（14.9%（14.3%；15.6%））学生报告了大麻消费，622 名（5.7%（5.2%；6.1%））学生在筛查时被确定为 CUD。男性吸食大麻的风险是女性的两倍，而患有 CUD 的风险是女性的三倍（男性为 22.4%和 10.6%，女性为 11.5%和 3.4%）。在多变量分析中，男性性别、酒精使用障碍、吸烟、父母离婚、身体攻击史和每周工作时间少于 40 小时的比例较低被确定为大麻消费和 CUD 的常见相关因素。催眠药物消费、精神科随访和性侵犯史被确定为与 CUD 具体相关的因素，表明这些因素与更严重的大麻消费有关。只有 17%的 CUD 学生报告了精神科随访。总之，这些结果表明，卫生政策应针对医学生中频繁的大麻消费，尤其是男性，且他们接受精神科随访的比例较低。我们发现 CUD 参与者中存在心理因素和催眠药物消费增加的情况，这表明应系统地向该群体提出精神科随访建议。
