青少年使用大麻与随后因情绪和焦虑障碍使用卫生服务的关系:基于人群的队列研究。

Youth cannabis use and subsequent health service use for mood and anxiety disorders: A population-based cohort study.

机构信息

Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada.

Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

Psychiatry Res. 2024 Feb;332:115694. doi: 10.1016/j.psychres.2023.115694. Epub 2023 Dec 25.

Abstract

Epidemiologic research suggests a modest association between youth cannabis use and mood and anxiety disorders (MADs). However, current evidence is based mostly on cohort studies using data from the 20th century when cannabis was significantly less potent than today. We linked population-based survey data from 2009 to 2012 with administrative records of health services covered under universal healthcare up to 2017. The cohort included youth aged 12 to 24 years at baseline living in Ontario, Canada with no prior MAD health service use (n = 8,252). We conducted a multivariable Cox model to estimate the association between cannabis use frequency (never, <weekly, weekly+) and MAD health service use (hospitalization, ED visit, or outpatient physician visit) in the following 3 years, adjusting for sociodemographic factors and other substance use. Compared to no cannabis use, <weekly use was significantly associated with subsequent MAD health service use (aHR=1.48; 95 % CI: 1.10-1.99) while weekly+ use was not (aHR=0.92; 95 % CI: 0.63-1.34). Sex and age interactions were not significant on the multiplicative or additive scales. This study found a modest longitudinal association between youth cannabis use and MAD health service use but no evidence of a linear dose-response relationship. Further research is needed to clarify these findings.

摘要

流行病学研究表明,青少年吸食大麻与情绪和焦虑障碍(MAD)之间存在一定关联。然而,目前的证据主要基于 20 世纪的队列研究,当时大麻的效力明显低于现在。我们将 2009 年至 2012 年的基于人群的调查数据与 2017 年之前全民医疗保健涵盖的健康服务管理记录相联系。该队列包括基线时年龄在 12 至 24 岁之间、居住在加拿大安大略省且无先前 MAD 健康服务使用史的青少年(n=8252)。我们采用多变量 Cox 模型,根据社会人口因素和其他物质使用情况,调整了在接下来的 3 年内大麻使用频率(从不、<每周、每周+)与 MAD 健康服务使用(住院、急诊就诊或门诊医生就诊)之间的关联。与不使用大麻相比,<每周使用与随后的 MAD 健康服务使用显著相关(调整后 HR=1.48;95%CI:1.10-1.99),而每周+使用则不然(调整后 HR=0.92;95%CI:0.63-1.34)。在乘法或加法尺度上,性别和年龄交互作用均不显著。本研究发现青少年大麻使用与 MAD 健康服务使用之间存在一定的纵向关联,但没有证据表明存在线性剂量-反应关系。需要进一步研究来阐明这些发现。

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