Sultan Alysha A, Goldstein Benjamin I, Blanco Carlos, Kennedy Kody G, Conway Kevin P, He Jian-Ping, Merikangas Kathleen
Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
J Affect Disord. 2025 Feb 15;371:268-278. doi: 10.1016/j.jad.2024.09.114. Epub 2024 Sep 17.
Despite evidence regarding prevalence and correlates of cannabis use (CU) and cannabis use disorder (CUD) in major depressive disorder (MDD) and bipolar disorder (BD) in adults, little is known about this topic among adolescents.
Data are from the 2001-2004 National Comorbidity Survey-Adolescent Supplement, an in-person, cross-sectional epidemiologic survey of mental disorders. Participants included adolescents, ages 13-18 years, with MDD (n = 354 with CU, n = 70 with CUD, n = 688 with no CU), BD (n = 79 with CU, n = 32 with CUD, n = 184 with no CU), or adolescents without mood disorders (n = 1413 with CU, n = 333 with CUD, n = 6970 with no CU). Analyses examined prevalence and correlates of CU and CUD within MDD and BD groups.
CU was most prevalent in adolescents with MDD followed by adolescents with BD then controls. CUD was most prevalent in adolescents with BD followed by adolescents with MDD then controls. In covariate-adjusted ordinal logistic regression models, within MDD and BD, CU and CUD groups had significantly higher odds of lifetime suicidal ideation/attempts, as well as other significant indicators of clinical severity.
Based on changes in cannabis acceptance, potency, and availability in the two decades since this study was conducted, present findings may underestimate adverse cannabis associations.
CU and CUD are both associated with adverse clinical characteristics in a community-based sample of adolescents with MDD and BD. Evidence that risks of cannabis use extend across the spectrum of use is important for adolescents with MDD and BD, in whom cannabis-related consequences tend to be more severe.
尽管有证据表明成年人中重度抑郁症（MDD）和双相情感障碍（BD）患者中大麻使用（CU）和大麻使用障碍（CUD）的患病率及相关因素，但青少年中关于此话题的了解甚少。
数据来自2001 - 2004年全国共病调查青少年补充调查，这是一项针对精神障碍的面对面横断面流行病学调查。参与者包括13 - 18岁的青少年，其中患有MDD的（有CU的n = 354，有CUD的n = 70，无CU的n = 688），患有BD的（有CU的n = 79，有CUD的n = 32，无CU的n = 184），或无情绪障碍的青少年（有CU的n = 1413，有CUD的n = 333，无CU的n = 6970）。分析研究了MDD和BD组中CU和CUD的患病率及相关因素。
CU在患有MDD的青少年中最为普遍，其次是患有BD的青少年，然后是对照组。CUD在患有BD的青少年中最为普遍，其次是患有MDD的青少年，然后是对照组。在协变量调整的有序逻辑回归模型中，在MDD和BD组内，CU和CUD组终身自杀意念/企图以及其他临床严重程度的显著指标的几率显著更高。
基于本研究开展后的二十年里大麻接受度、效力和可获得性的变化，目前的研究结果可能低估了大麻的不良关联。
在以社区为基础的患有MDD和BD的青少年样本中，CU和CUD均与不良临床特征相关。大麻使用风险贯穿使用范围的证据对于患有MDD和BD的青少年很重要，在这些青少年中，与大麻相关的后果往往更严重。
