University of Turku, Faculty of Medicine, Department of Psychiatry, Turku, Finland; Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland.
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Psychiatry, Seinäjoki Central Hospital, Seinäjoki, Finland.
Schizophr Res. 2022 Aug;246:95-102. doi: 10.1016/j.schres.2022.06.014. Epub 2022 Jun 23.
Longitudinal studies examining the effect of cannabis exposure (CE) on the prognosis of adolescents with psychotic-like experiences (PLEs) are scarce. We examined trajectories of mental health in adolescents with PLEs and cannabis exposure.
The Northern Finland Birth Cohort 1986 (n = 6552) with linkage to nationwide register data was used. Information on lifetime cannabis exposure was collected when participants were aged 15/16. Register-based outcome data on diagnoses made in clinical practice were obtained until age 33. Logistic regression was used to study the association of PLE/CE patterns and subsequent psychiatric disorders. The group with neither PLEs nor CE was utilized as the reference group. Parental psychiatric disorders, family structure, sex, frequent alcohol intoxications, daily smoking and illicit substance use other than cannabis were adjusted for.
In all, 6552 subjects (49.2 % males) were included in analysis. PLEs with cannabis exposure were associated with any psychiatric disorder (OR = 2.59; 95 % CI 1.82-3.68), psychotic disorders (OR = 3.86; 95 % CI 1.83-8.11), mood disorders (OR 4.07; 95 % CI 2.74-6.04), depressive disorders (OR = 4.35; 95 % CI 2.93-6.48), anxiety disorders (OR = 2.06; 95 % CI 1.34-3.17) and substance use disorders (OR = 2.26; 95 % CI 1.13-4.50) compared to reference group. Effect sizes were greater for group with both PLEs and cannabis use than for group with PLEs only.
Early-onset cannabis use is an adverse prognostic marker for adolescents with PLEs after extensive confounder control including other substance use.
纵向研究考察大麻暴露（CE）对出现类似精神病体验（PLEs）的青少年预后的影响，此类研究较少。我们研究了有 PLEs 和大麻暴露的青少年的心理健康轨迹。
我们使用了芬兰北部出生队列 1986 年（n=6552）的数据，并与全国登记数据相链接。当参与者年龄为 15/16 岁时，收集了终生大麻暴露信息。通过临床实践中的登记数据获得了直到 33 岁的诊断结果。使用逻辑回归来研究 PLE/CE 模式与随后的精神障碍之间的关联。未出现 PLEs 且无 CE 的组被用作参考组。调整了父母的精神障碍、家庭结构、性别、经常醉酒、每日吸烟和除大麻以外的非法药物使用。
共纳入 6552 名受试者（49.2%为男性）进行分析。有 PLEs 且有 CE 的青少年与任何精神障碍（OR=2.59；95%CI 1.82-3.68）、精神病性障碍（OR=3.86；95%CI 1.83-8.11）、心境障碍（OR=4.07；95%CI 2.74-6.04）、抑郁障碍（OR=4.35；95%CI 2.93-6.48）、焦虑障碍（OR=2.06；95%CI 1.34-3.17）和物质使用障碍（OR=2.26；95%CI 1.13-4.50）有关，与参考组相比。与仅出现 PLEs 组相比，同时出现 PLEs 和大麻使用的组的效应大小更大。
在广泛控制混杂因素（包括其他物质使用）后，青少年早期使用大麻是出现 PLEs 的不良预后标志物。
