Cannabismissbrauch erhöht das Risiko für spätere depressive Symptome (OR ~4), nicht umgekehrt.
Zusammenfassung
Prospektive ECA-Kohortenstudie (N gesamt=1.920; Analyse-Subkohorte ohne Baseline-Depression n=849). Cannabis-Abusus bei Baseline → 4-fach erhöhtes Risiko für Depressionssymptome im 14-Jahres-Follow-up, nach Adjustierung für Alter, Geschlecht, antisoziale Symptome (OR ca. 4). Erhöhte Suizidideation und Anhedonie. Umgekehrte Richtung nicht signifikant (p>0.05): Baseline-Depression sagte keinen Cannabis-Abusus voraus.
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PopulationErwachsene aus der Baltimore Epidemiologic Catchment Area (ECA) Studie, n=1.920 (Teilkohorte ohne Baseline-Depressionssymptome: n=849; Teilkohorte ohne Baseline-Cannabismissbrauch: n=1.837)
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InterventionCannabismissbrauch (Diagnose nach Diagnostic Interview Schedule) zum Baseline-Zeitpunkt 1980
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KontrolleKein Cannabismissbrauch zum Baseline-Zeitpunkt
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OutcomePersonen mit Cannabismissbrauch zu Baseline hatten ein vierfach erhöhtes Risiko für Depressionssymptome im Follow-up (OR ~4,0, nach Adjustierung für Alter, Geschlecht, antisoziale Symptome und weitere Kovariaten); Depressionssymptome zu Baseline sagten Cannabismissbrauch im Follow-up nicht signifikant vorher
Vertrauen in die Evidenz
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Zweite von vier GRADE-Stufen, die Effektschätzung ist begrenzt verlässlich.
<h4>Objective</h4>This study sought to estimate the degree to which cannabis abuse is a risk factor for depressive symptoms rather than an effort to self-medicate depression.<h4>Method</h4>Participants (N=1,920) in the 1980 Baltimore Epidemiologic Catchment Area (ECA) study who were reassessed between 1994 and 1996 as part of a follow-up study provided the data. The analysis focused on two cohorts: those who reported no depressive symptoms at baseline (N=849) and those with no diagnosis of cannabis abuse at baseline (N=1,837). Symptoms of depression, cannabis abuse, and other psychiatric disorders were assessed with the Diagnostic Interview Schedule.<h4>Results</h4>In participants with no baseline depressive symptoms, those with a diagnosis of cannabis abuse at baseline were four times more likely than those with no cannabis abuse diagnosis to have depressive symptoms at the follow-up assessment, after adjusting for age, gender, antisocial symptoms, and other baseline covariates. In particular, these participants were more likely to have experienced suicidal ideation and anhedonia during the follow-up period. Among the participants who had no diagnosis of cannabis abuse at baseline, depressive symptoms at baseline failed to significantly predict cannabis abuse at the follow-up assessment.<h4>Conclusions</h4>Further research is needed to identify characteristics of individuals who abuse cannabis that account for their higher risk of depression to estimate the degree of impairment resulting from their depression.