Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
New York State Psychiatric Institute, New York.
JAMA Netw Open. 2020 Aug 3;3(8):e2013802. doi: 10.1001/jamanetworkopen.2020.13802.
Despite studies showing that repeated cannabis use may worsen depressive symptoms, the popular media increasingly presents cannabis as beneficial to mental health, and many members of the public view cannabis as beneficial for depression. Therefore, cannabis use among individuals with depression may be becoming more prevalent.
To examine the association of depression with past-month cannabis use among US adults and the time trends for this association from 2005 to 2016.
DESIGN, SETTING, AND PARTICIPANTS: This repeated cross-sectional study used data from 16 216 adults aged 20 to 59 years who were surveyed by the National Health and Nutrition Examination Survey, a national, annual, cross-sectional survey in the United States, between 2005 and 2016. Data analysis was conducted from January to February 2020.
Survey year and depression, as indicated by a score of at least 10 on the Patient Health Questionnaire-9.
Any past-month cannabis use (ie, ≥1 use in the past 30 days) and daily or near-daily past-month cannabis use (ie, ≥20 uses in the past 30 days). Logistic regression was used to examine time trends in the prevalence of cannabis use, depression, and the association between cannabis use and depression from 2005 to 2016.
The final analysis included 16 216 adults, of whom 7768 (weighted percentage, 48.9%) were men, 6809 (weighted percentage, 66.4%) were non-Hispanic White participants, and 9494 (weighted percentage, 65.6%) had at least some college education. They had a weighted mean age of 39.12 (95% CI, 38.23-39.40) years. Individuals with depression had 1.90 (95% CI, 1.62-2.24) times the odds of any past-month cannabis use and 2.29 (95% CI, 1.80-2.92) times the odds of daily or near-daily cannabis use compared with those without depression. The association between cannabis use and depression increased significantly from 2005 to 2016. The odds ratio for depression and any past-month cannabis use increased from 1.46 (95% CI, 1.07-1.99) in 2005 to 2006 to 2.30 (95% CI, 1.82-2.91) in 2015 to 2016. The odds ratio for depression and daily or near-daily past-month cannabis use increased from 1.37 (95% CI, 0.81-2.32) in 2005 to 2006 to 3.16 (95% CI, 2.23-4.48) in 2015 to 2016.
The findings of this study indicate that individuals with depression are at increasing risk of cannabis use, with a particularly strong increase in daily or near-daily cannabis use. Clinicians should be aware of these trends and the evidence that cannabis does not treat depression effectively when discussing cannabis use with patients.
尽管有研究表明，反复使用大麻可能会加重抑郁症状，但大众媒体越来越多地将大麻描述为对心理健康有益，许多公众认为大麻对抑郁症有益。因此，患有抑郁症的人可能越来越多地使用大麻。
在美国成年人中，调查抑郁与过去一个月大麻使用之间的关联，以及 2005 年至 2016 年期间这种关联的时间趋势。
设计、地点和参与者：这是一项重复的横断面研究，使用了 2005 年至 2016 年期间参加美国全国健康和营养调查的 16216 名年龄在 20 至 59 岁的成年人的数据。该调查是一项全国性的、年度的、横断面的调查。数据分析于 2020 年 1 月至 2 月进行。
调查年份和抑郁，由患者健康问卷-9 的得分至少为 10 分表示。
任何过去一个月的大麻使用（即过去 30 天内使用≥1 次）和过去一个月的每日或接近每日大麻使用（即过去 30 天内使用≥20 次）。使用 logistic 回归分析了 2005 年至 2016 年期间大麻使用、抑郁的流行趋势以及大麻使用与抑郁之间的关联的时间趋势。
最终分析包括 16216 名成年人，其中 7768 名（加权百分比，48.9%）为男性，6809 名（加权百分比，66.4%）为非西班牙裔白人参与者，9494 名（加权百分比，65.6%）具有至少一些大学教育。他们的加权平均年龄为 39.12 岁（95%置信区间，38.23-39.40）。有抑郁的个体使用过去一个月的大麻的可能性是没有抑郁的个体的 1.90 倍（95%置信区间，1.62-2.24），使用每日或接近每日大麻的可能性是没有抑郁的个体的 2.29 倍（95%置信区间，1.80-2.92）。大麻使用与抑郁之间的关联从 2005 年到 2016 年显著增加。与没有抑郁的个体相比，抑郁和任何过去一个月的大麻使用之间的比值比从 2005 年至 2006 年的 1.46（95%置信区间，1.07-1.99）增加到 2015 年至 2016 年的 2.30（95%置信区间，1.82-2.91）。抑郁和每日或接近每日过去一个月的大麻使用之间的比值比从 2005 年至 2006 年的 1.37（95%置信区间，0.81-2.32）增加到 2015 年至 2016 年的 3.16（95%置信区间，2.23-4.48）。
这项研究的结果表明，患有抑郁症的个体使用大麻的风险越来越大，尤其是每日或接近每日使用大麻的风险显著增加。临床医生在与患者讨论大麻使用时，应意识到这些趋势和大麻不能有效治疗抑郁症的证据。
