论文标题：The association between cannabis use and suicidal behavior in patients with psychiatric disorders: an analysis of sex differences

期刊：

作者：Leen Naji et al

发表时间： 2018/6/11

数字识别码：10.1186/s13293-018-0182-x

原文链接：

近期，加拿大的研究人员在Biology of Sex Differences上发表了一项将精神病患者使用大麻及其自杀行为风险与正常人群对比的研究，探究使用大麻是否会增加精神病患者的自杀行为。这是研究人员首次对比两个群体的大麻使用情况与自杀风险，该研究的结果将有助于医务人员评估精神病患者的自杀风险。

之前的许多研究表明大麻使用与高自杀风险之间存在直接关系。然而，很少有研究探索这一结论是否适用于如精神疾病患者这样的高自杀风险人群。作为同类研究中的第一个（发表于Biology of Sex Differences），加拿大研究小组研究了大麻使用对精神疾病患者群体的影响，实验结果令人诧异：适度使用大麻不会增加他们的自杀风险。

与此同时，研究发现其他可能影响自杀风险的因素对研究人群的影响与之前针对正常人群的研究结果相似：情绪障碍、失业、男性大量使用大麻均会增加自杀风险。究竟为何会出现这样的研究结果呢？

研究人员对研究结果提出了一些可能解释——本研究的研究对象中很多既往就有药物或毒品滥用史，这意味着他们的神经精神状态可能已经发生改变，因此很难确定大麻使用对自杀行为的影响。正常人群很少滥用药物或毒物，因此比较容易观察到大麻的影响。

虽然本研究样本体量较小，且存在其他合并影响因素，但这是同类研究第一次指出大麻使用与自杀风险之间的关系可能并不如想象的那么可靠，特别是在罹患精神疾病的人群中。

本研究还有另一个值得注意的地方，以往研究认为的一般人群中自杀行为的性别差异在这一组研究中几乎完全被消除。传统研究发现，女性更容易发生自杀行为（男性自杀行为较少，但自杀成功率更高）。在这项新的研究中，研究人员在患精神疾病的人群中并未观察到类似的现象。

此次的研究结果将鼓励科研人员进行进一步研究，同时也提醒与这些高风险人群打交道的医务人员评估自杀风险时需要注意，情绪障碍和其他社会因素发挥的作用可能远大于使用大麻。

摘要：

Background

Cannabis is the most commonly used illicit drug. In the general population, its use has been linked to a heightened propensity for suicidal behavior (SB). We hypothesize that this association varies in patients with psychiatric disorders. SB is known to vary by sex and therefore an investigation of cannabis’ association with SB must consider sex differences. The purpose of this study is to investigate the association between cannabis use and suicide attempts in men and women with psychiatric disorders.

Methods

We merged data collected for two studies based in Ontario, Canada (n = 985). We employed a multivariable logistic regression to assess the association between cannabis use and suicide attempts in men and women with psychiatric disorders.

Results

We analyzed data from 465 men and 444 women. Amongst these, 112 men and 158 women had attempted suicide. The average age of our participants was 40 years (standard deviation (SD) 12.4). We found no significant association between suicide attempts and cannabis use in men (odds ratio (OR) = 1.34, 95% confidence interval (CI) 0.81, 2.22, p = 0.260) or women (OR = 0.97, 95% CI 0.61, 1.54, p = 0.884). In a sensitivity analysis using a sample of patients with substance use disorder only, the heaviness of cannabis use was associated with small but significant association with SB in men (OR = 1.03, 95% CI 1.01, 1.05, p = 0.007).

Conclusion

Our findings indicate that there is no association between cannabis use and suicidal behavior in men or women with psychiatric disorders unlike what was reported for the general population, though the heaviness of cannabis use may have an effect in men. The impact of cannabis use in psychiatric disorders needs ongoing examination in light of its common use, impending legalization with expected increased access and the uncertainty about cannabis’ effects on prognosis of psychiatric disorders. In addition, research should continue to investigate modifiable risk factors of SB in this population of which cannabis is not a significant factor based on this study.

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期刊介绍：is the official journal of the Organization for the Study of Sex Differences, and a publication of the Society for Womens Health Research.

2017 Journal Metrics

Citation Impact

3.543 - 2-year Impact Factor

4.360 - 5-year Impact Factor

0.923 - Source Normalized Impact per Paper (SNIP)

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