Myhre Martin Ø, Rognli Eline Borger, Walby Fredrik A, Bramness Jørgen G, Mehlum Lars
Institute for Clinical Medicine, National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway.
Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Soc Psychiatry Psychiatr Epidemiol. 2024 Oct 28. doi: 10.1007/s00127-024-02781-4.
The temporal trend of suicide in patients with cannabis use disorder (CUD) is important to investigate, considering the recent increases in THC concentration in cannabis products. This study describes the annual suicide rates in patients with CUD from 2010 to 2021. To investigate if any change in suicide rate was specific to CUD, we compared these suicide rates with corresponding data for patients with alcohol use disorders (AUD) and other substance use disorders (SUDs).
The study used a time series design. We used a national registry linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry from 2010 to 2021, including patients with CUD (ICD-10 code F12), AUD (F10), or other SUDs (F11; F13-F16; F18-F19) who died by suicide, supplemented with the total number of patients treated with specific disorders to estimate the suicide rates. The trend was analyzed by comparing the annual suicide rate to 2010 and using Poisson regression, adjusting for gender, age, and mental disorders.
We found increased annual incidence rate ratios for patients with CUD in 2018 (IRR = 2.14 (95% CI 1.14-3.99)) and onwards and an increasing time trend over the study period (IRR = 1.08 (1.05-1.12)). No increases in trends were found for AUD or other SUDs. The time trend for CUD was attenuated when adjusting for depressive or anxiety disorders (aIRR = 1.00 (0.92-1.08)) or other SUDs (aIRR = 0.96 (0.87-1.06)).
Increasing suicide rates were found in patients with CUD. Comorbid anxiety and depression or other SUDs, but not other mental disorders, could partly explain these results.
鉴于大麻制品中四氢大麻酚（THC）浓度最近有所上升，调查大麻使用障碍（CUD）患者自杀的时间趋势很重要。本研究描述了2010年至2021年CUD患者的年度自杀率。为了调查自杀率的任何变化是否特定于CUD，我们将这些自杀率与酒精使用障碍（AUD）患者和其他物质使用障碍（SUD）患者的相应数据进行了比较。
该研究采用了时间序列设计。我们使用了2010年至2021年挪威死亡原因登记处和挪威患者登记处之间的全国登记链接，包括因自杀死亡的CUD（国际疾病分类第十版代码F12）、AUD（F10）或其他SUD（F11；F13 - F16；F18 - F19）患者，并补充了接受特定疾病治疗的患者总数以估计自杀率。通过将年度自杀率与2010年进行比较并使用泊松回归分析趋势，同时对性别、年龄和精神障碍进行调整。
我们发现2018年及以后CUD患者的年度发病率比值增加（发病率比值（IRR）= 2.14（95%置信区间1.14 - 3.99）），并且在研究期间呈上升的时间趋势（IRR = 1.08（1.05 - 1.12））。未发现AUD或其他SUD的趋势增加。在对抑郁或焦虑障碍（调整后的发病率比值（aIRR）= 1.00（0.92 - 1.08））或其他SUD进行调整后，CUD的时间趋势减弱（aIRR = 0.96（0.87 - 1.06））。
发现CUD患者的自杀率在上升。共病的焦虑和抑郁或其他SUD，但不是其他精神障碍，可能部分解释了这些结果。
