Rabiee Rynaz, Lundin Andreas, Agardh Emilie, Hensing Gunnel, Allebeck Peter, Danielsson Anna-Karin
Karolinska Institutet, Department of Global Public Health, Stockholm, Sweden.
Karolinska Institutet, Department of Global Public Health, Stockholm, Sweden.
Drug Alcohol Depend. 2020 Nov 1;216:108332. doi: 10.1016/j.drugalcdep.2020.108332. Epub 2020 Sep 30.
The associations between cannabis use and anxiety or depression remain unclear. If cannabis affects these conditions, it is of interest to examine possible changes in cannabis use over time, in relation to anxiety and depression, as cannabis potency has increased in recent decades.
Cohorts from the Women and Alcohol in Gothenburg study (n = 1 100), from three time periods were used to examine associations over time between cannabis use and anxiety and depression. Logistic regression analyses were used and relative excess risk due to interaction (RERI) was calculated to examine potential additive interactions between period of cannabis use, cannabis use, and anxiety or depression.
Cannabis use was associated with anxiety in the oldest cohort (examined 1986-1992, born 1955/65), OR = 5.14 (1.67-15.80, 95 % CI), and with both anxiety and depression in the youngest cohort (examined 2000-2015, born 1980/93), OR = 1.66 (1.00-2.74, 95 % CI) and 2.37 (1.45-3.86, 95 % CI), respectively. RERI was significant between cannabis use and depression in the youngest cohort when compared with older cohorts (1.68 (0.45-2.92, 95 % CI)).
Cross-sectional data prevent statements on causality, though between-cohort comparisons are possible.
The association between cannabis use and depression becomes more pronounced when adding the effect of period of use rather than looking at the effect of cannabis use itself. This study provides clinicians and public health workers with scientifically underpinned knowledge regarding the link between cannabis use and depression, of particular importance given increasing cannabis potency.
大麻使用与焦虑或抑郁之间的关联仍不明确。如果大麻会影响这些状况,那么随着近几十年来大麻效力的增加,研究大麻使用随时间的可能变化与焦虑和抑郁的关系就很有意义。
来自哥德堡妇女与酒精研究的三个时间段的队列(n = 1100)被用于研究大麻使用与焦虑和抑郁随时间的关联。使用逻辑回归分析,并计算交互作用导致的相对超额风险(RERI),以检验大麻使用时间段、大麻使用与焦虑或抑郁之间潜在的相加交互作用。
在最年长的队列(1986 - 1992年进行检查,出生于1955/65年)中,大麻使用与焦虑相关,比值比(OR)= 5.14(1.67 - 15.80,95%置信区间);在最年轻的队列(2000 - 2015年进行检查,出生于1980/93年)中,大麻使用与焦虑和抑郁均相关,OR分别为1.66(1.00 - 2.74,95%置信区间)和2.37(1.45 - 3.86,95%置信区间)。与较年长队列相比,最年轻队列中大麻使用与抑郁之间的RERI显著(1.68(0.45 - 2.92,95%置信区间))。
横断面数据虽可进行队列间比较,但无法得出因果关系的结论。
考虑大麻使用时间段的影响而非仅关注大麻使用本身的影响时,大麻使用与抑郁之间的关联更为明显。本研究为临床医生和公共卫生工作者提供了关于大麻使用与抑郁之间联系的科学依据,鉴于大麻效力不断增加,这一点尤为重要。