Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Programme on Addictions, HIV, STI and Viral Hepatitis, Barcelona, Spain.
Eur Addict Res. 2023;29(5):344-352. doi: 10.1159/000530331. Epub 2023 Aug 16.
According to the literature, early initiation to cannabis use and a dependent pattern of use are important risk factors for the development of mental health disorders. However, there are few cohort studies which look at the development of mental health disorders associated with cannabis use among young people with cannabis use disorder (CUD). The aim of the study was to determine the cumulative incidence of mental health disorders and the risk of developing mental health disorders among minors who commenced treatment for CUD in Catalonia during 2015-2019.
This was a retrospective fixed cohort study, matched for confounding variables, based on data from the Catalan Health Surveillance System. The exposed cohort comprised young people who entered treatment for CUD during 2015-2019 (n = 948) and who were minors on the date of commencing treatment. Matching was done with a paired cohort (n = 4,737), according to confounding variables. Individuals with a diagnosis of a mental health disorder prior to the study period were excluded. The cumulative incidence was calculated for mental health disorders for the exposed and the paired cohorts and stratified by type of mental disorder. Incidence rate ratios were estimated using the conditional Poisson model with robust variance, stratified by sex.
The cumulative incidence for development of a mental health disorder was 19.6% in the exposed cohort and 3.1% in the paired cohort; with higher incidence among females (females 32.7%; males 15.8%). The exposed cohort had an 8.7 times increased risk of developing a mental health disorder than the paired cohort. The most frequent diagnoses were reaction to severe stress, adjustment disorder, and personality disorders.
This study confirmed that the exposed cohort was at increased risk of developing mental health disorders compared to the paired cohort. To date, few studies have analyzed the association between cannabis use and the development of mental health disorders, considering cannabis dependence. Further studies should be undertaken considering CUD. In addition, more studies are needed to understand the factors that determine the development of CUD. Further research in these areas would contribute to the design of prevention strategies aimed at those young individuals with a higher risk of developing cannabis dependence and suffering its consequences.
根据文献，早期开始使用大麻和依赖型使用模式是心理健康障碍发展的重要危险因素。然而，很少有队列研究关注与大麻使用障碍（CUD）相关的大麻使用对年轻人心理健康障碍的发展。本研究的目的是确定 2015 年至 2019 年期间在加泰罗尼亚接受 CUD 治疗的未成年人中与大麻使用相关的心理健康障碍的累积发病率和发病风险。
这是一项基于加泰罗尼亚健康监测系统数据的回顾性固定队列研究，针对混杂变量进行了匹配。暴露队列包括 2015 年至 2019 年期间接受 CUD 治疗的年轻人（n=948），且在开始治疗时为未成年人。根据混杂变量，对配对队列（n=4737）进行了匹配。排除研究前患有精神健康障碍的个体。计算了暴露队列和配对队列的精神健康障碍累积发病率，并按精神障碍类型进行分层。使用条件泊松模型和稳健方差，按性别分层，估计发病率比。
暴露队列的精神健康障碍发展累积发病率为 19.6%，配对队列为 3.1%；女性发病率较高（女性 32.7%；男性 15.8%）。暴露队列发展精神健康障碍的风险比配对队列高 8.7 倍。最常见的诊断是严重应激反应、适应障碍和人格障碍。
本研究证实，与配对队列相比，暴露队列发展精神健康障碍的风险更高。迄今为止，很少有研究分析考虑到大麻依赖的情况下，大麻使用与精神健康障碍发展之间的关联。应进一步开展研究以了解 CUD。此外，还需要更多的研究来了解决定 CUD 发展的因素。在这些领域的进一步研究将有助于设计针对那些发展大麻依赖风险较高和遭受其后果的年轻人的预防策略。
