在一个基于社区的成人多动症样本中使用大麻：患病率、对症状的影响及兴奋剂副作用
Cannabis Use in a Community-Based Sample of Adults Diagnosed With ADHD: Prevalence, Impact on Symptoms, and Stimulant Side Effects.
作者信息
Ryan Jennie E, Herens Allison, Fruchtman Mitchell, Veliz Philip, Kelly Erin L, Worster Brooke
机构信息
Thomas Jefferson University, Philadelphia, PA, USA.
University of Michigan, Ann Arbor, USA.
出版信息
J Atten Disord. 2025 Aug 28:10870547251364575. doi: 10.1177/10870547251364575.
AIM
Assess prevalence and correlates of cannabis use in adults with attention-deficit/hyperactivity disorder (ADHD) and explore its impact on comorbidities, symptoms, and side effects of prescription stimulants.
METHODS
An anonymous online survey (April to July 2023) was emailed to 9,274 potential adult participants with a documented ADHD diagnosis, based on ICD-10 codes in the electronic medical record, which was secondarily verified by self-report. A total of 900 participants completed the survey. The 46-item survey covered demographics, medical history, prescription stimulant use, cannabis use, and its impact on ADHD symptoms and prescribed stimulant side effects, prescription stimulant misuse, cannabis use disorder, and health-related quality of life.
RESULTS
In this large sample of adults diagnosed with ADHD, 75% reported ever using cannabis, with 41% reporting prior 30-day use. Groups of cannabis users were categorized into three groups; (1) no recent use (including never; = 458); (2) non-daily use (<30 days in past month; = 256); and (3) daily use (≥30 days in past month; = 112). Compared to non-daily cannabis users, daily cannabis users showed comparable rates of prescription stimulant misuse (29% vs. 37%, OR = 1.39, 95% CI [0.87, 2.23], = .166), and substance use disorder diagnoses (2% vs. 4%, OR = 1.54, 95% CI [0.43, 5.58], = .508), but higher rates of cannabis use disorder (38% vs. 62%, OR = 2.67, 95% CI [1.69, 4.22], < .001). Daily cannabis users were more likely to report fair or poor general health compared to non-daily cannabis users (24% vs. 11%, OR = 2.58, 95% CI [1.44, 4.64], = .001). Daily cannabis users were more likely to report a comorbid diagnosis of anxiety (70% vs. 48%, OR = 2.55, 95% CI [1.59, 4.10], < .001), depression (54% vs. 35%, OR = 2.24, 95% CI [1.42, 3.53], < .001), bipolar disorder (15% vs. 5%, OR = 3.345, 95% CI [1.56, 7.15], = .002), and post-traumatic stress disorder (PTSD) (30% vs. 14%, OR = 2.752, 95% CI [1.61, 4.71], < .001), compared to non-daily cannabis users. Among participants who ever used cannabis, 278 (42%) reported they had used cannabis to manage their ADHD symptoms. Compared to non-daily cannabis users, daily cannabis users were significantly more likely to report that cannabis use improved ADHD symptoms of mental frustration (OR = 2.39, 95% CI [1.36, 4.19], = .002) and impulsivity (OR = 1.69, 95% CI [1.07, 2.69], = .026). Daily cannabis users were more likely to report that cannabis use worsened ADHD symptoms of inattention (OR = .59, 95% CI [0.36, 0.98], = .043) compared to non-daily cannabis users. Participants reported mixed effects of cannabis use on anxiety: 156 noted improvements, while 34 reported worsening.
CONCLUSION
In this sample of adults diagnosed with ADHD, cannabis use was prevalent, with daily users showing higher rates of cannabis use disorder and co-morbid psychiatric diagnoses compared to non-daily users, highlighting the need for clinicians to screen for cannabis use disorder and psychiatric comorbidities. Cannabis users reported mixed effects of cannabis on ADHD symptoms and anxiety. Further research is warranted to understand the complex relationship between cannabis use, ADHD symptoms, and mental health.
目的
评估注意力缺陷多动障碍（ADHD）成人患者中大麻使用的患病率及其相关因素，并探讨其对共病、症状以及处方兴奋剂副作用的影响。
方法
2023年4月至7月，通过电子邮件向9274名有ADHD诊断记录的潜在成年参与者发送了一份匿名在线调查问卷，该诊断基于电子病历中的国际疾病分类第十版（ICD - 10）编码，并通过自我报告进行二次验证。共有900名参与者完成了调查。这份46项的调查问卷涵盖了人口统计学、病史、处方兴奋剂使用情况、大麻使用情况及其对ADHD症状和处方兴奋剂副作用的影响、处方兴奋剂滥用情况、大麻使用障碍以及与健康相关的生活质量。
结果
在这个被诊断为ADHD的成年人大样本中，75%的人报告曾使用过大麻,其中41%的人报告在过去30天内使用过。大麻使用者被分为三组：（1）近期未使用（包括从未使用；n = 458）；（2）非每日使用（过去一个月内<30天；n = 256）；（3）每日使用（过去一个月内≥30天；n = 112）。与非每日大麻使用者相比，每日大麻使用者的处方兴奋剂滥用率相当（29%对37%，OR = 1.39，95% CI [0.87, 2.23]，P = 0.166），物质使用障碍诊断率也相当（2%对4%，OR = 1.54，95% CI [0.43, 5.58]，P = 0.508），但大麻使用障碍率更高（38%对62%，OR = 2.67，95% CI [1.69, 4.22]，P < 0.001）。与非每日大麻使用者相比，每日大麻使用者更有可能报告总体健康状况为中等或较差（24%对11%，OR = 2.58，95% CI [1.44, 4.64]，P = 0.xxx）。与非每日大麻使用者相比，每日大麻使用者更有可能报告共病焦虑症（70%对48%，OR = 2.55，95% CI [1.59, 4.10]，P < 0.001）、抑郁症（54%对35%，OR = 2.24，95% CI [1.42, 3.53]，P < 0.001）、双相情感障碍（15%对5%，OR = 3.345，95% CI [1.56, 7.15]，P = 0.002）和创伤后应激障碍（PTSD）（30%对14%，OR = 2.752，95% CI [1.61, 4.71]，P < 0.001）。在曾经使用过大麻的参与者中，278人（42%）报告他们使用大麻来控制ADHD症状。与非每日大麻使用者相比，每日大麻使用者更有可能报告大麻使用改善了ADHD的精神挫折症状（OR = 2.39，95% CI [1.36, 4.19]，P = 0.xxx）和冲动症状（OR = 1.69，95% CI [1.07, 2.69]，P = 0.026）。与非每日大麻使用者相比，每日大麻使用者更有可能报告大麻使用会使ADHD的注意力不集中症状恶化（OR = 0.59，95% CI [0.36, 0.98]，P = 0.043）。参与者报告大麻使用对焦虑有混合影响：156人指出有改善，而34人报告有恶化。
结论
在这个被诊断为ADHD的成年人大样本中，大麻使用很普遍，与非每日使用者相比，每日使用者的大麻使用障碍和共病精神疾病诊断率更高，这突出了临床医生筛查大麻使用障碍和精神疾病共病的必要性。大麻使用者报告大麻对ADHD症状和焦虑有混合影响。有必要进一步研究以了解大麻使用、ADHD症状和心理健康之间的复杂关系。
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