De la Peña-Arteaga Víctor, Nogueira Sarah O, Lynskey Michael, Hines Lindsey A
Bellvitge Biomedical Research Institute, Barcelona, Spain.
Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
Front Psychiatry. 2021 May 26;12:631245. doi: 10.3389/fpsyt.2021.631245. eCollection 2021.
Among adolescents, cannabis use is a health concern due to associations with drug addiction and mental health disorders across the life course. It has been shown that childhood maltreatment is associated with drug addiction in adulthood. However, a better understanding of the relationship between maltreatment and drug use may improve targeted prevention and interventions. The aim of this systematic review is to describe the association between exposure to childhood maltreatment, specifically physical and sexual abuse, with adolescent cannabis use. A systematic search strategy was applied to Embase, PsycINFO, and Ovid MEDLINE(R) databases. Methods followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Abstract and title screening was performed to identify papers which reported an estimate of the association between childhood physical or sexual abuse and adolescent cannabis use. Full text screening of each paper was performed, and data were extracted and study quality assessed. Weighted means meta-analysis was performed on studies reporting odds ratios as effect estimates. Of 8,780 screened articles, 13 were identified for inclusion. Eight papers received a quality rating score indicating lower risk of bias. Eleven papers reported the relationship between childhood sexual abuse and adolescent cannabis use; effect estimates ranged from AOR 0.53-AOR 2.18 (weighted mean OR 1.29, 95% CI 1.08-1.49). The relationship between childhood physical abuse and adolescent cannabis use was reported in 7 papers; effect estimates ranged from AOR 1.25-AOR 1.87 (weighted mean OR 1.39, 95% CI 1.12-1.66). Differences in the strength of the evidence were observed by the method of exposure ascertainment, and there was some evidence of differences in association by gender, age of cannabis initiation, and the severity of the abuse. This systematic review indicates childhood physical or sexual abuse may increase risk of adolescent-onset cannabis use. Few studies considered variation in timing of onset, or by gender. Adolescent cannabis use precedes is strongly associated with increased risk of negative mental health outcomes; further exploration of adolescent cannabis use's place on the causal pathway between childhood abuse and adult mental health problems is warranted to improve intervention.
在青少年中,大麻使用是一个健康问题,因为它与整个生命过程中的药物成瘾和精神健康障碍有关。研究表明,童年期受虐待与成年后的药物成瘾有关。然而,更好地理解虐待与药物使用之间的关系可能会改善有针对性的预防和干预措施。本系统评价的目的是描述童年期受虐待,特别是身体虐待和性虐待,与青少年大麻使用之间的关联。我们对Embase、PsycINFO和Ovid MEDLINE(R)数据库应用了系统检索策略。方法遵循系统评价和Meta分析的首选报告项目(PRISMA)指南。进行摘要和标题筛选,以确定报告童年期身体或性虐待与青少年大麻使用之间关联估计值的论文。对每篇论文进行全文筛选,提取数据并评估研究质量。对报告比值比作为效应估计值的研究进行加权均值Meta分析。在筛选的8780篇文章中,有13篇被确定纳入。8篇论文获得了表明偏倚风险较低的质量评分。11篇论文报告了童年期性虐待与青少年大麻使用之间的关系;效应估计值范围为调整后比值比(AOR)0.53 - AOR 2.18(加权均值OR 1.29,95%置信区间1.08 - 1.49)。7篇论文报告了童年期身体虐待与青少年大麻使用之间的关系;效应估计值范围为AOR 1.25 - AOR 1.87(加权均值OR 1.39,95%置信区间1.12 - 1.66)。通过暴露确定方法观察到证据强度的差异,并且有一些证据表明在关联方面存在性别、开始使用大麻的年龄和虐待严重程度的差异。本系统评价表明,童年期身体或性虐待可能会增加青少年开始使用大麻的风险。很少有研究考虑发病时间或性别的差异。青少年开始使用大麻与负面心理健康结果风险增加密切相关;有必要进一步探讨青少年大麻使用在童年期虐待与成人心理健康问题因果路径中的位置,以改善干预措施。