Department of Psychiatry, University of California, San Diego, CA, USA; VA San Diego Healthcare System, San Diego, CA, USA.
Department of Psychiatry, University of California, San Diego, CA, USA.
J Affect Disord. 2021 Jan 1;278:528-535. doi: 10.1016/j.jad.2020.09.099. Epub 2020 Sep 29.
Cannabis use is associated with psychiatric illness and suicidality, which are prevalent among U.S. military veterans. However, the psychiatric burden of cannabis use and cannabis use disorder (CUD) among veterans is unclear. Using data from a nationally representative sample of veterans, we evaluated associations of lifetime cannabis use and CUD with psychiatric problems, suicidality, and treatment utilization.
Participants were 3,157 veterans aged 21 to 96 years from the National Health and Resilience in Veterans Study (NHRVS). Cannabis use and CUD were assessed using the Mini International Neuropsychiatric Interview. Psychiatric morbidities, suicidal ideation and attempts, and treatment utilization were assessed and compared between three cannabis groups: [1] no lifetime cannabis use (never-use); [2] lifetime cannabis use but never met criteria for CUD (non-CUD cannabis use); [3] lifetime CUD (CUD).
Relative to the never-use group, veterans who used cannabis had elevated odds of current and lifetime posttraumatic stress disorder (PTSD), mood, anxiety, and substance use disorders, current suicidal ideation, lifetime suicide attempts, and current and lifetime mental health treatment utilization [odds ratios (ORs)=1.5-8.3]. Veterans with CUD had higher odds of current and lifetime PTSD, mood, and anxiety disorders, lifetime nicotine and alcohol dependence, and current suicidal ideation, relative to veterans who used cannabis but never met criteria for CUD (ORs=1.6-2.7).
The cross-sectional design of this study precludes causal inference.
Cannabis use and CUD are associated with substantial psychiatric and suicide-related burden among veterans, highlighting the need for screening, education, and treatment to mitigate potential cannabis-related harm.
大麻使用与精神疾病和自杀意念相关，而这些问题在美国退伍军人中较为普遍。然而，退伍军人中大麻使用和大麻使用障碍（CUD）的精神负担尚不清楚。本研究使用来自具有全国代表性的退伍军人样本的数据，评估了终身大麻使用和 CUD 与精神问题、自杀意念和自杀行为以及治疗利用之间的关联。
研究参与者为来自国家健康和退伍军人复原力研究（NHRVS）的 3157 名年龄在 21 至 96 岁的退伍军人。使用 Mini 国际神经精神访谈（MINI）评估大麻使用和 CUD。评估了精神障碍、自杀意念和自杀企图以及治疗利用情况，并在三个大麻组之间进行了比较：[1] 无终身大麻使用（从不使用）；[2] 终身大麻使用但从未符合 CUD 标准（非 CUD 大麻使用）；[3] 终身 CUD（CUD）。
与从不使用组相比，使用大麻的退伍军人出现当前和终身创伤后应激障碍（PTSD）、心境、焦虑和物质使用障碍、当前自杀意念、终生自杀企图以及当前和终身心理健康治疗利用的可能性更高[比值比（ORs）=1.5-8.3]。与使用大麻但从未符合 CUD 标准的退伍军人相比，患有 CUD 的退伍军人出现当前和终身 PTSD、心境和焦虑障碍、终生尼古丁和酒精依赖以及当前自杀意念的可能性更高（ORs=1.6-2.7）。
本研究的横断面设计限制了因果关系的推断。
大麻使用和 CUD 与退伍军人中的大量精神疾病和自杀相关问题相关，这突显了筛查、教育和治疗的必要性，以减轻潜在的大麻相关危害。
